Andorra

General************************************This small country is situated between France and Spain. Because of its elevation and proximity to the Pyrenees the climate is generally pleasant throughout the year. Climate**************
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*********************During the summer months the temperatures can rise to 30c but there is usually a cooling breeze. Lightening storms can occur during the summer months associated with torrential rain. Sun Exposure and Dehydration***************************************Those from Northern Europe can develop significant sun exposure and so remember to use a wide brimmed hat when necessary. The altitude can also lead to significant tiredness and dehydration so take sufficient initial rest and drink plenty of fluids. Safety & Security************************************The level of crime throughout the country directed at tourists is very low. Nevertheless take care of your personal belongings at all times and use hotel safety boxes where possible. Local Customs************************************There are strict laws regarding the use of illegal drugs. Make sure you have sufficient supplies of any medication you required for your trip and that it is clearly marked. The European E111 form is not accepted in Andorra and so it is essential that you have sufficient travel insurance for your trip. Winter Sports************************************Andorra is one of the regions where many travel to partake of their winter sport facilities. Generally this is well controlled and one of the safer regions. Nevertheless, make certain your travel insurance is adequate for the activities you are planning to undertake. Vaccination************************************The only standard vaccine to consider for Andorra would be tetanus in line with many other developed countries of the world.

Government in Andorra vows to kick habit of cigarette advertising
Pollution Andorra
- 2 years ago

Date: Thu, 12 Jul 2018 15:24:06 +0200

Andorra la Vella, Andorra, July 12, 2018 (AFP) - The tax haven of Andorra has long been a favourite destination for smokers looking to stock up on cheap cigarettes, but the enclave said Thursday that it would soon stop advertising the fact. The government said it had signed up to the World Health Organization's (WHO) anti-tobacco convention, which aims to encourage people to quit smoking and combat contraband sales. "The goal is to contribute to public health and pursue the fight against trafficking," government spokesman Jordi Cinca said at a press conference.

The tiny principality of Andorra, perched in the Pyrenees on the border between France and Spain, attracts millions of shoppers each year to duty-free stores, where prices of alcohol, cigarettes, electronics and clothes can be up to 20 percent cheaper than elsewhere in the EU. High taxes on tobacco imposed by many countries to help people kick smoking make Andorra's cigarettes a particularly good deal. The average pack costs just three euros ($3.50) compared with eight euros in France, which has said it will gradually raise the price to 10 euros a pack by November 2020.

Tobacco sales bring in some 110 million euros a year for Andorra, whose economy is otherwise based almost entirely on tourism. It is also an enticing destination for smugglers, with French and Spanish border agents regularly seizing cartons from people trying to sneak them out, either by car or by hiking down the mountain trails which criss-cross the Pyrenees. No date has been set for the advertising ban, which will come into effect three months after the ratification of the WHO accord is voted by parliament.

Population in Andorra witness first strike since 1933
Strikes Andorra
- 2 years ago

Date: Fri, 16 Mar 2018 02:41:51 +0100

Andorra la Vella, Andorra, March 16, 2018 (AFP) - The tiny principality of Andorra is witnessing a once in a generation phenomenon -- a widespread strike. Around a third of civil servants across the mountainous micro-state have walked out to protest proposed reforms to their sector in what has been described as Andorra's first large-scale strike since 1933.

With no negotiation breakthrough in sight, picket lines are expected to be manned again on Friday with customs officers, police, teachers and prison staff among those taking part. The first major strike in 85 years was sparked by plans from the government of Antoni Marti to reform civil servant contracts. He has assured officials "will not do an hour more" work under the reforms and that 49 million euros would be allocated for the next 25 years to supplement civil servant salaries. But government workers are unconvinced with unions warning the reforms could risk their 35 hour working week and pay.

Customs officers involved in the strike interrupted traffic on the Andorran-Spanish border this week, according to unions, while some 80 percent of teachers have walked out of classes. Strikers have occupied the government's main administrative building and held noisy protests outside parliament calling for Marti's resignation. "We have started collecting signatures to demand the resignation of the head of government and now nobody will stop us," Gabriel Ubach, spokesman for the public service union, told reporters.

Report on 2016 outbreak of Norovirus in Catalonia (Spain) linked to water from Andorra
Disease Norovirus Andorra
- 3 years ago

A recent Dispatch article published in the Centers for Disease Control and Prevention (CDC)'s Emerging Infectious Diseases journal, offers insight into a large norovirus outbreak that sprung up in Spain in 2016 that had been linked with bottled spring water. The Public Health Agency of Catalonia (ASPCAT) reported a staggering 4136 cases of gastroenteritis from 11-25 Apr 2016. Of the 4136 cases, 6 individuals required hospitalization. The CDC defines a "case-patient" as an "exposed person who had vomiting or diarrhoea (3 or more loose stools within 24 hours)," as well as 2 or more of the following symptoms: nausea, stomach pain, or fever.

ASPCAT investigators traced back the outbreak to contaminated bottled spring water in office water coolers. The water came from a source in Andorra, a small independent principality located between Spain and France. Norovirus is a "very contagious virus," according to the CDC, and it is common for individuals to become infected by eating contaminated food. Although it is possible to be infected by consuming contaminated drinking water, this mode of transmission is "rare in developed countries," according to the article.

The investigators collected water samples from a total of 4 19-L water coolers in 2 different offices located in Barcelona, "from which affected persons had drunk; samples 1 and 2 came from 2 water coolers in one office, while samples 3 and 4 came from 2 water coolers in another office. Using "positively charged glass wool and polyethylene glycol precipitation for virus concentration," the investigators tested the samples.

"We detected high RNA levels for norovirus genotype I and II, around 103 and 104 genome copies/L, in 2 of the 4 water cooler samples concentrated by glass wool filtration and polyethylene glycol precipitation," according to the article. The investigators noted that a drawback of using molecular methods is that they are not able to differentiate between particles that are infectious and those that are not. Therefore, they "predicted the infectivity of norovirus in the concentrated samples by treating the samples with the nucleic acid intercalating dye PMA propidium monoazide and Triton X surfactant before RT-qPCR," which allowed them to "distinguish between virions with intact and altered capsids."

In those 2 water samples, they found high genome copy values -- 49 and 327 genome copies/L for norovirus genotype I and 33 and 660 genomes copies/L for norovirus genotype II. This was not an unexpected finding, due to the large number of infected individuals associated with the outbreak. Through "PMA/Triton treatment before RT-qPCR assays," the investigators found that the proportion of infected virions accounted for 0.3% to 5.6% of the total number of physical particles in the water samples, "which was enough to cause gastrointestinal illness."

The investigators also analyzed faecal samples collected from infected individuals who worked at the office in which the 1st 2 water samples were collected. They detected the following genotypes in those faecal samples: GI.2 and GII.17. In the faecal samples collected from the other office, they isolated the following genotypes: GII.4/Sydney/2012, GI.2, GII.17, and GII.2.

"We hypothesize that the spring water was contaminated by all 4 strains (GI.2, GII.2, GII.4, and GII.17) but levels of viral contamination for each genotype were not homogeneous in all bottled coolers," the investigators wrote. "We may have detected only the GII.4 genotype in water samples 1 and 2 because of a higher concentration of this specific genotype or because of bias caused by the sampling, concentration, and molecular detection procedures."

The investigators admit one limitation to their study: the small number of water samples collected and analyzed. They attribute this to the fact that on 15 Apr 2016, 4 days after the onset of the outbreak, the company that produced the drinking water recalled over 6150 containers of water "of suspected quality" as a precautionary measure. The recall prevented the investigators from collecting more samples to assess, according to the article.

Although the exact cause of the contamination has not yet been identified, the investigators posit that "the high number of affected persons from 381 offices that received water coolers, and the many different genotypes found in some patients' faecal specimens" suggest that the spring aquifer had been contaminated by "sewage pollution," and the Andorra Ministry of Health and Welfare banned further use of the spring.

The investigators suggest that assessing commercially-produced mineral waters for different harmful pathogens, such as norovirus would be beneficial. They note, however, that creating, enhancing, and managing such "virus surveillance systems" would be costly. Thus, the investigators suggest taking a "balanced approach to keep both the cost and the time required for the analyses within feasibility limits." [Byline: Kristi Rosa]

=====================

[The interesting article published in the September 2017 issue of Emerging Infectious Diseases is:

ANDORRA LA VELLA, Andorra, Dec 26, 2013 (AFP) - A Spanish skier and a French snowboarder have died in avalanches in different mountain ranges in Europe, officials said Thursday.

The 27-year-old skier, a woman from Barcelona, died Wednesday while going off-piste alone in the Soldeu resort in Andorra, in the Pyrenees mountains between France and Spain, a resort manager told AFP. Although she was rescued within 10 minutes, after her glove was spotted on the surface, she was unable to be revived despite a helicopter dash to hospital.

In the Italian Alps, close to the border with France, a 24-year-old Frenchman who was snowboarding with three friends on a closed run died Thursday when an avalanche swept over him in the resort town of Les Arnauds. Local officials said he succumbed to multiple injuries, asphyxia and hypothermia.

Avalanches are common in Europe's ski resorts at this time of year, when early snows are heavy with moisture, and several deaths occur each winter. Last Sunday, a 35-year-old Frenchman died in an avalanche in the Alps near the Italian border while on a three-day trek with a friend.

Date: Fri 7 Feb 2003 From: Jaime R. Torres Source: EFE Salud, Thu 6 Feb 2003 (translated by Maria Jacobs) [edited] -------------------------------------------------- Close to 300 students in one school and 173 tourists staying in 7 hotels in the Principality of Andorra have been affected by outbreaks of gastroenteritis that, according to local authorities, are not related to each other. Monica Codina, Minister of Health, stated that the outbreak that has affected almost 300 children and 8 adults in the San Ermengol school was detected last Monday [3 Feb 2003] but that it may have started Wednesday or Thursday of the previous week. The epidemiological surveys of a group of pre-school and grammar school students that may also be affected have not been performed yet. Also pending are the results of the microbiological tests of the food and water served in the school dining room, but the minister has indicated that the probable cause of the outbreak is the fact that water pitchers were filled with hoses directly from the faucet. The Minister stated that this outbreak of gastroenteritis is not related to the one that affected 173 tourists, most of them young people on holiday, who where staying in 7 hotels of the Principality. The government is also investigating the cause of this outbreak and has indicated that an anomaly in the system that supplies water to the hotels was detected, requiring a process of chlorination, which has not been carried out due to the heavy snowfall of the past few days. * * * * * * * * * * [The suspicion that defective water supplies may be responsible for all of these independent outbreaks suggests that the etiologic agent may be an enterovirus, hepatitis A virus, or non-viral, rather than one of the noroviruses associated with sudden-onset viral gastroenteritis. Information on the outcome of diagnostic tests in progress would be welcomed. - ProMed Mod.CP]

San Juan, March 15, 2020 (AFP) - The US territory of Puerto Rico on Sunday ordered a 9:00 pm to 5:00 am curfew to stem the spread of the novel coronavirus, the strongest measure yet taken on American soil. It took effect immediately and lasts until March 30. "Faced with the possibility of transmission and propagation of the virus, I have ordered the imposition of a curfew for all residents of Puerto Rico," Governor Wanda Vazquez announced in a video message. "We must take every precaution to ensure that we do not become potential carriers," Vazquez said.

The Caribbean territory of 2.9 million, whose residents are US citizens, also will close many businesses from Sunday until the end of the month, she said. That includes malls, movie theaters, concert venues, gyms, bars and other businesses that bring together large crowds on the island popular with tourists. The exceptions will be businesses in the food supply chain, and in the medical care system, as well as drugstores, gas stations, banks and senior citizens' group homes.

At night, only those who are providing or receiving medical care, or carrying out essential duties, will be allowed to be on Puerto Rico's streets. Anyone defying the curfew faces a six-month jail term and a fine of up to $5,000. The island declared a state of emergency when its first cases were reported March 12. The island has reported five cases. On Friday, Vazquez accepted the resignation of Health Secretary Rafael Rodriguez Mercado, who was under fire for his handling the coronavirus emergency.

Recently, island residents were irate when two warehouses were found to be filled with abandoned supplies, apparently never used after Hurricanes Irma and Maria in 2017. The storms' one-two punch left Puerto Ricans without power for months and killed nearly 3,000 people, according to the local government's official numbers. President Donald Trump has accused the Puerto Rican government of incompetence and siphoning off hurricane relief money. The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.

Yauco, Puerto Rico, Jan 16, 2020 (AFP) - Living out in the open, their nerves on edge after a series of earthquakes that have shaken Puerto Rico, some 5,000 people are hoping that their president, Donald Trump, will heed the island's plea to be designated a disaster zone and free up much-needed aid. Since December 28, more than 1,000 tremors have rattled the US island territory in the Caribbean, which just two years ago was devastated by two powerful hurricanes in quick succession.

In Yauco, one of the areas worst hit by the earthquakes, dozens of people were sitting on cot beds Wednesday in the parking lot of a municipal stadium, sheltered from the sun by white tents and blue tarps handed out by the federal disaster management agency, known as FEMA. "The most difficult thing is the psychological aspect," said Wilfredo Rodriguez, 31. His house had been fractured by the seismic movement and he has spent a week living with his kids, aged six and 10, under an awning. "We are living in constant fear of another powerful tremor," he said.

He only returns to his house to wash, then hurries back to the shelter. "We worry that there'll be a more powerful tremor while we are inside the house," he said. Throughout the day, volunteers arrive to hand out food and toys for the children who fill the shelters: schools have been suspended because the buildings are not sturdy enough to withstand another quake. The island's earthquake detection system has registered 1,104 tremors in the past two weeks alone, of which 186 could be felt by the population. By comparison, during the whole of 2019 there were 6,442 tremors, of which just 62 could be felt by people on the island.

Further south, in Guanico, Juan Santiago decided to move into a shelter on Saturday after a tremor of 5.9 on the Richter scale hit the island. "The mountain shook and rocks and earth started to come down," said the 30-year-old. "My house has a crack in it and is about to fall down," he added. His home had weathered the Category Five winds of Hurricane Maria in September 2017 and of Hurricane Irma which followed it just two weeks later. "It's different to a hurricane. What is happening now is much nastier," he said.

As he was talking the earth shook again, a tremor of 5.2 magnitude. Vehicles rocked like hammocks in the wind, but the quake-hardened victims barely reacted. The houses in this part of the island are mostly rudimentary constructions built by the people who live in them with scant resources available in the mountains, where no regulations stipulate that buildings should be earthquake resistant. The government of Puerto Rico said that as of Monday, there were 4,924 people living in 28 shelters in 14 municipalities. There were no figures on how many buildings had been damaged or destroyed.

- Seeking disaster designation -Puerto Rico's governor Wanda Vazquez Garced called on Trump to declare the earthquake a disaster and clear the way for desperately needed aid. Trump had declared an emergency days before, but the governor wanted more. The declaration of an emergency frees up to $5 million dollars in aid for the island, although Congress can bump that figure up. But if the situation is designated a disaster, there is no ceiling on funding, a FEMA spokesman said. On Wednesday, the government said it would release $8.2 billion in delayed hurricane relief that had been stalled after the president threatened to divert Puerto Rico's emergency funds to help pay for his wall on the US-Mexico border.

In the past few days there have been growing calls among Democratic lawmakers for Trump to declare the situation in Puerto Rico a disaster. It is a delicate subject, as Trump has accused the government of Puerto Rico of incompetence and of siphoning off hurricane relief money, triggering a public spat between the president and the mayor of San Juan, Carmen Yulin Cruz, as well as the former governor Ricardo Rossello, who was forced to step down last summer amid massive protests. The Puerto Rican leaders accused Trump of treating the population of the island like second class citizens.

Washington, Jan 11, 2020 (AFP) - A 5.9 magnitude earthquake rocked Puerto Rico Saturday, the latest in a series of powerful tremors that have shaken the US territory in recent days, the US Geological Survey reported.

The latest quake occurred at 8:54 am local time (1254 GMT) around 13 kilometres (eight miles) southeast of Guanica, a town on the island's southern Caribbean coastline that was hard hit by earlier quakes. The USGS revised its initial report of a 6.0 magnitude quake to 5.9. It follows a 6.4 magnitude quake Tuesday that killed one person, knocked

out electric power and caused widespread damage.

Puerto Rico Governor Wanda Vazquez declared a state of emergency after Tuesday's quake, which forced an automatic shutdown of the power grid. Puerto Rico's electric power authority reported outages in the towns of Ponce, Lares, Adjuntas and San German after the latest quake. The Pacific Tsunami Information Center in Hawaii issued a statement saying there was "no significant tsunami threat" but a small possibility of tsunami waves along coasts nearest the epicentre.

The island is still recovering from Hurricane Maria, which came ashore more than two years ago as a devastating Category 4 storm. Starting December 28, a wave of tremors have swept the island, putting residents on edge. The 6.4 quake on January 7 came a day after a 5.8 magnitude quake; it was followed by major aftershocks. Saturday's quakes were also preceded by a string of smaller tremors.

Guayanilla, Puerto Rico, Jan 7, 2020 (AFP) - Puerto Rico's governor declared a state of emergency on Tuesday after a powerful 6.4 magnitude earthquake killed at least one person in the south of the island and caused widespread damage. Governor Wanda Vazquez said the declaration would allow for the activation of National Guard troops in the US territory still recovering from a devastating 2017 hurricane. The US Geological Survey said the quake struck at 4:24 am (0824 GMT) with the epicenter off the coast of the southern city of Ponce, and was followed by more than a dozen aftershocks.

Tuesday's quake was the most powerful in a series of tremors that have shaken the island since December 28. Scientists initially sent out an alert about a potential tsunami but it was later canceled. The island's electricity authority said the quake had forced an automatic shutdown of the power grid, already severely damaged by Hurricane Maria more than two years ago. The worst damage appeared to be in towns on the southwest coast, including Ponce, Guayanilla and Guanica. El Nuevo Dia newspaper said a 73-year-old man died after a wall fell in his home in Ponce. Eight others there were reported injured.

Two power plants in Guayanilla sustained major damage, the Puerto Rico Electric Power Authority said. The city could be without power for two weeks, its mayor Nelson Torres Yordan said. Celebrity chef Jose Andres announced that a charity he runs, World Central Kitchen, had started serving meals and distributing solar-powered lamps in quake-hit areas. Vazquez announced that $130 million in emergency aid funding will be disbursed. On social media, people wrote of being shaken awake by the force of the quake. One woman on Twitter said she had been "wrenched from sleep." "Everybody is awake & scared all over," she posted. In Guayanilla, the Inmaculada Concepcion church, built in 1841, was heavily damaged. Volunteers salvaged statues and other valuable items from the ruins as a priest consoled distraught parishioners.

- 'Be safe' -A 5.8 magnitude quake on Monday toppled some structures, caused power outages and small landslides, but did not result in any casualties. It also destroyed a popular tourist landmark, Punta Ventana, a natural stone arch that crumbled on the island's southern coast. Vazquez, the governor, said government employees were being given the day off on Tuesday to take care of their families. "We want everyone to be safe," she said. She said ports were undamaged and there are several weeks' supply of gasoline, diesel and natural gas stored so people need not worry about shortages.

The White House said President Donald Trump had been briefed and Pete Gaynor, head of the Federal Emergency Management Agency (FEMA), had been in touch with the governor. Trump's administration came under severe criticism for its response to Hurricane Maria. The Category 4 storm destroyed the island's already shaky power grid, overwhelmed public services, left many residents homeless and claimed several thousand lives, according to government estimates.

Washington, Jan 7, 2020 (AFP) - A strong earthquake struck south of Puerto Rico early Tuesday, the US Geological Survey said, the latest in a series of tremors that have shaken the island since December 28. The shallow 6.5 magnitude quake struck 13.6 kilometres (8.5 miles) south of the city of Ponce, the USGS said, revising down its initial reading of 6.6. The quake struck just off the US territory's southern Caribbean coastline at 4:24 am local time (0824 GMT). "The whole island is without power," the director of Puerto Rico Electric Power Authority, Jose Ortiz, told local media.

Puerto Rico's governor Wanda Vazquez Garced posted on Twitter that the government's security protocols had been activated. She said government employees were not expected at work, adding: "We want everyone to be safe." On social media, people wrote of being shaken awake by the force of the quake. One woman on Twitter said she had been "wrenched from sleep", adding "Everybody is awake & scared all over."

Dramatic images also shared on social media appeared to show widespread damage in the town of Guayanilla, home to around 20,000 people, as well as nearby Guanica. The mayor of Guayanilla told local news channel NotiUno that the town's church had collapsed in the incident.

An alert issued by the Tsunami Warning Center immediately following the earthquake was later cancelled. Tuesday's quake was the strongest of a series of tremors that have shaken the island since December 28, topping Monday's 5.8 quake. That earthquake toppled houses and caused power outages, but there were no reports of casualties.

Benin

COUNTRY DESCRIPTION:Benin is a developing country in West Africa. Its political capital is Porto Novo. However, its administrative capital, Cotonou, is Benin's largest city and the
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site of most government, commercial, and tourist activity. Read the Department of State Background Notes on Benin for additional information.

ENTRY/EXIT REQUIREMENTS: A passport and visa are required. Visas are not routinely available at the airport. Visitors to Benin should also carry the WHO Yellow Card (“Carte Jaune”) indicating that they have been vaccinated for yellow fever. Contact the Embassy of Benin for the most current visa information. The Embassy is located at: 2124 Kalorama Road NW, Washington, DC 20008; tel: 202-232-6656.

Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:U.S. citizens should avoid crowds, political rallies, and street demonstrations and maintain security awareness at all times.U.S. citizens should not walk on the beach alone at any time of day. It is also highly recommended not to carry a passport or valuables when walking in any part of the city. Travelers should carry a notarized photocopy of the photo page of their passport (see Crime section). They should not walk around the city after dark, and should take particular care to avoid the beach and isolated areas near the beach after dark.The ocean currents along the coast are extremely strong and treacherous with rough surf and a strong undertow, and several people drown each year.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME: Street robbery is a significant problem in Cotonou. Robbery and mugging occur along the Boulevard de France (the beach road by the Marina and Novotel Hotels) and on the beaches near hotels frequented by international visitors. Most of the reported incidents involve the use of force, often by armed persons, with occasional minor injury to the victim. Travelers should avoid isolated and poorly lit areas and should not walk around the city or the beaches between dusk and dawn. Even in daylight hours, foreigners on the beach near Cotonou are frequent victims of robberies. When visiting the beach, travelers should not bring valuables and should carry only a photocopy of their passport. If you are a victim of crime, you should contact the U.S. Embassy immediately. There has been a continued increase in the number of robberies and carjacking incidents after dark, both within metropolitan Cotonou and on highways and rural roads outside of major metropolitan areas. Motorists are urged to be wary of the risk of carjacking. Keep the windows of your vehicle rolled up and the doors locked. Stay alert for signs of suspicious behavior by other motorists or pedestrians that may lead to carjacking, such as attempts to stop a moving vehicle for no obvious reason. Travelers should avoid driving outside the city of Cotonou after dark and should exercise extreme caution when driving in Cotonou after dark (see Traffic Safety and Road Conditions below). Overland travel to Nigeria is dangerous near the Benin/Nigeria border due to unofficial checkpoints and highway banditry. Travelers should avoid the use of credit cards and automated teller machines (ATMs) in Benin due to a high rate of fraud. Perpetrators of business and other kinds of fraud often target foreigners, including Americans. While such fraud schemes in the past have been largely associated with Nigeria, they are now prevalent throughout West Africa, including Benin, and are more frequently perpetrated by Beninese criminals. Business scams are not always easy to recognize, and any unsolicited business proposal should be carefully scrutinized. There are, nevertheless, some indicators that are warnings of a probable scam. Look out for:

Any offer of a substantial percentage of a very large sum of money to be transferred into your account, in return for your "discretion" or "confidentiality";

Any deal that seems too good to be true; Requests for signed and stamped, blank letterhead or invoices, or for bank account or credit card information; Requests for urgent air shipment, accompanied by an instrument of payment whose genuineness cannot immediately be established; Solicitations claiming the soliciting party has personal ties to high government officials; Requests for payment, in advance, of transfer taxes or incorporation fees; Statements that your name was provided to the soliciting party either by someone you do not know or by "a reliable contact"; Promises of advance payment for services to the Beninese government; and Any offer of a charitable donation. These scams, which may appear to be legitimate business deals requiring advance payments on contracts, pose a danger of both financial loss and physical harm. Recently more American citizens have been targeted. The perpetrators of such scams sometimes pose as attorneys. One common ploy is to request fees for “registration” with fictitious government offices or regulatory authorities. The best way to avoid becoming a victim of advance-fee fraud is common sense – if it looks too good to be true, it probably is. Travelers should carefully check out any unsolicited business proposal originating in Benin before committing any funds, providing any goods or services, or undertaking any travel. For additional information, please see the Department of State’s Bureau of Consular Affairs brochure, International Financial Scams.

Scams may also involve persons posing as singles on Internet dating sites or as online acquaintances who then get into trouble and require money to be "rescued." If you are asked to send money by someone you meet online please contact the U.S. Embassy before doing so.

INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION: Medical facilities in Benin are limited and not all medicines are available. Travelers should bring their own supplies of prescription drugs and preventive medicines. Not all medicines and prescription drugs available in Benin are USFDA-approved. Malaria is a serious risk to travelers to Benin. For information on malaria, its prevention, protection from insect bites, and anti-malarial drugs, please visit the CDC Travelers' Health web site at http://www.cdc.gov/malaria/.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s website at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Benin is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

With the exception of the road linking Cotonou in the south to Malanville on the border with Niger in the north, and from Parakou in central Benin to Natitingou in the northwestern part of the country, roads in Benin are generally in poor condition and are often impassable during the rainy season. Benin's unpaved roads vary widely in quality; deep sand and potholes are common. During the rainy season from mid-June to mid-September, dirt roads often become impassable. Four-wheel drive vehicles with full spare tires and emergency equipment are recommended. Most of the main streets in Cotonou are paved, but side streets are often dirt with deep potholes. Traffic moves on the right, as in the United States. Cotonou has no public transportation system; many Beninese people rely on bicycles, mopeds, motorbikes, and zemidjans (moped taxis). All official Americans are required to wear safety helmets when on a motorcycle and are strongly discouraged from using zemidjans. Travelers using zemidjans, particularly at night, are much more vulnerable to being mugged, assaulted or robbed. Buses and bush taxis offer service in the interior. Gasoline smuggled from Nigeria is widely available in glass bottles and jugs at informal roadside stands throughout Cotonou and much of the country. This gasoline is of unreliable quality, often containing water or other contaminants that can damage or disable your vehicle. Drivers should purchase fuel only from official service stations. There are periodic gas shortages, which can be particularly acute in the north of the country where there are few service stations. U.S. citizens traveling by road should exercise extreme caution. Poorly maintained and overloaded transport and cargo vehicles frequently break down and cause accidents. Drivers often place branches or leaves in the road to indicate a broken down vehicle is in the roadway. Undisciplined drivers move unpredictably through traffic. Construction work is often poorly indicated. Speed bumps, commonly used on paved roads in and near villages, are seldom indicated. Drivers must be on guard against people and livestock wandering into or across the roads. Nighttime driving is particularly hazardous as vehicles frequently lack headlights and/or taillights, and brake lights are often burned out. With few exceptions, Cotonou and other cities lack any street lighting, and lighting on roads between population centers is non-existent. The U.S. Embassy in Cotonou prohibits non-essential travel outside of metropolitan areas after dusk by official Americans and strongly urges all U.S. citizens to avoid night driving as well. There have been numerous carjackings and robberies on roads in Benin after dark, several of which resulted in murder when the driver refused to comply with the assailants' demands. The National Police periodically conduct vehicle checks at provisional roadblocks in an effort to improve road safety and reduce the increasing number of carjackings. When stopped at such a roadblock, you must have all of the vehicle's documentation available to present to the authorities. Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at http://www.benintourisme.com.

AVIATION SAFETY OVERSIGHT: As there is no direct commercial air service to the United States by carriers registered in Benin, the U.S. Federal Aviation Administration (FAA) has not assessed Benin’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:U.S. citizens are advised to keep a notarized photocopy of the photo page of their passport with them at all times when traveling in Benin.The Embassy has had a few reports of officials requesting a "gift" to facilitate official administrative matters (e.g., customs entry). Such requests should be politely but firmly declined. It is prohibited to photograph government buildings and other official sites, such as military installations, without the formal consent of the Government of Benin. In general, it is always best to be courteous and ask permission before taking pictures of people. Beninese citizens may react angrily if photographed without their prior approval. Obtaining customs clearance at the port of Cotonou for donated items shipped to Benin from the United States may be a lengthy process. In addition, to obtain a waiver of customs duties on donated items, the donating organization must secure prior written approval from the Government of Benin. Please contact the U.S. Embassy in Cotonou for more detailed information.Please see our Customs Information.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Benin laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Benin are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties.

CHILDREN'S ISSUES: For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION / EMBASSY LOCATION:Americans living or traveling in Benin are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site so that they can obtain updated information on travel and security within Benin. Americans withoutInternet access may register directly with the U.S. Embassy. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Rue Caporal Anani Bernard in Cotonou. The Embassy's mailing address is B.P. 2012, Cotonou, Benin. The 24-hour telephone numbers are (229) 21-30-06-50, 21-30-05-13, and 21-30-17-92. The Embassy’s general fax number is (229) 21-30-06-70; the Consular Section’s fax number is (229) 21-30-66-82; http://cotonou.usembassy.gov/.* * *This replaces the Country Specific Information for Benin dated August 17th, 2007 to update sections on Safety and Security and Traffic Safety and Road Conditions.

French special forces free 4 hostages in Burkina Faso taken from Pendjari National Park in neighbouring Benin
Tourism Benin
- 1 year ago

Date: Fri, 10 May 2019 19:38:30 +0200By Hazel WARD and Daphne BENOIT

Paris, May 10, 2019 (AFP) - French special forces have freed two French hostages, an American and a South Korean in northern Burkina Faso in an overnight raid in which two soldiers died, authorities announced Friday. The operation was launched to free two French tourists who had disappeared while on holiday in the remote Pendjari National Park in neighbouring Benin on May 1.

But during the raid, the French troops were surprised to discover two women also in captivity, with top officials saying they had been held for 28 days. The French tourists were identified as Patrick Picque, 51, and Laurent Lassimouillas, 46, but the women's identities were not immediately clear. "No one was aware of (the women's) presence," French Defence Minister Florence Parly told reporters, while French armed forces chief Francois Lecointre said. "We know little about these other two hostages," Parly told reporters, saying that even Seoul and Washington did not appear to be aware the pair were in increasingly unstable Burkina Faso. The raid was approved by French President Emmanuel Macron in what was seen as the last opportunity to stop the hostages being transferred to lawless territory in Mali to the north.

Parly said it was "too early to say" who had snatched the two French nationals from Benin, which has long been an island of stability in a region where Islamist militants are increasingly active. "The message to terrorists and criminal gangs is clear: those who attack France and its nationals know that we will not spare any effort to track them down, find them and neutralise them," she said. Four of the six kidnappers were killed in the raid. French forces, helped by intelligence provided by the United States, had been tracking the kidnappers for several days as they travelled across the semi-desert terrain of eastern Burkina Faso from Benin to Mali. They seized the opportunity to prevent "the transfer of the hostages to another terrorist organisation in Mali," Lecointre said, referring to the Macina Liberation Front (FLM). The FLM is a jihadist group formed in 2015 and headed by a radical Malian preacher, Amadou Koufa. It is aligned with Al-Qaeda in the region.

- US intelligence support -In a statement, Macron congratulated the special forces on the operation, in which he also expressed sorrow over the death of the two soldiers "who gave their lives to save those of our citizens". And Parly thanked authorities in Benin and Burkina Faso for their help with the "complex operation", as well as the United States which provided intelligence and support.

The operation was also made possible by the presence of France's Operation Barkhane, which counts some 4,500 troops deployed in Mali, Burkina Faso, Niger and Chad to help local forces battle jihadist groups. American special forces and drones are also known to operate in the violence-wracked Sahel region, which France fears could become further destabilised as jihadist groups are pushed out of north Africa, Iraq and Syria. Burkina Faso has suffered from increasingly frequent and deadly attacks attributed to a number of jihadist groups, including the Ansarul Islam group, the Group to Support Islam and Muslims (GSIM) and Islamic State in the Greater Sahara.

- Relief and sadness -The French tourists -- Patrick Picque who works in a Paris jewellery shop, and Laurent Lassimouillas a piano teacher, -- went missing with their guide on the last leg of their holiday in usually peaceful Benin. The Pendjari wildlife reserve, which is famed for its elephants and lions, lies close to the porous border with Burkina Faso. The badly disfigured body of their guide was found shortly after they disappeared, as well as their abandoned four-wheel Toyota truck. The two freed men will be flown back to France on Saturday, alongside the South Korean woman, where they will be met on arrival by Macron and other top French officials. Washington thanked the French forces for freeing the American hostage, with France saying she would likely be "repatriated independently" from the other three.

The two dead French soldiers were named as Cedric de Pierrepont and Alain Bertoncello, decorated naval special forces members born in 1986 and 1991 respectively. They were part of the prestigious Hubert commando unit of the French naval special forces which was deployed to the Sahel at the end of March. A total of 24 French soldiers have died in the region since 2013 when France intervened to drive back jihadist groups who had taken control of northern Mali. The last death was on April 2.

Concern that husband and wife in Kwara State of Nigeria with Lassa Fever could have been infected in Benin
Disease Lassa Fever Benin
- 1 year ago

The Kwara state government has confirmed 2 cases of Lassa fever infecting a husband and wife in the state.

Speaking with newsmen on Tuesday [15 Jan 2019] at a news briefing, the Kwara commissioner for health, Alhaji Usman Rifun-Kolo, said the outbreak of Lassa fever was identified in a farm settlement in Taberu, Baruten local government area.

He explained that the 2 cases of the disease affected a husband and wife, natives of Benin republic, which shares a border with the state. He added that the husband and wife are farming in Baruten. "These cases of Lassa fever originated from Benin republic, whose citizen have interrelations with people in the Baruten area," he said.

According to him, the husband and wife were diagnosed in a health facility, and the state government had already deployed a disease-surveillance team to identify those who have been in contact with the patients.

Rifun-Kolo further explained that the surveillance team identified 4 people with a history of fever in the area. He said that the 4 cases raised suspicion of Lassa fever, which prompted them to take samples from the individuals for further investigation. He noted that the 4 individuals have commenced treatment in Taberu, Baruten LGA.

=====================

[The above report states that the couple was infected in Benin, although the timeline when that may have occurred is not given. The report also mentions 4 individuals in the Kwara state who had a history of Lassa fever, implying that the virus is present in that state in Nigeria as well. In December [2018], there were Lassa fever cases in Benin that were imported from Nigeria as well as infections that were locally acquired in Benin, so the Lassa fever cases cross the border in both directions. The source of the infecting virus for any of these cases is not mentioned. - ProMED Mod.TY

Minister of health Benjamin Hounkpatin confirmed on Wednesday [26 Dec 2018] 4 new cases of Lassa haemorrhagic fever in Benin, including one in Cotonou. This occurred in the period from 15-26 Dec 2018.

In the case of Cotonou, a 28-year-old (has been infected). His case was detected on 24 Dec [2018], but his illness commenced the previous week. He had a fever, a cough, a cold, and fatigue. Due to the persistence of the cough and cold, and with the appearance of traces of blood in nasal discharge on 24 Dec 2018, the alert was given.

The patient was placed in isolation on [Tue 25 Dec 2018], and on the morning of Wed 26 Dec 2018, his result from the laboratory came back positive [for Lassa fever]. Subsequently, the patient was isolated and put on treatment.

According to the details provided by Hounkpatin, there is no indication of travel [by the patient] to an epidemic locality of Lassa fever. According to the patient's statements, there is no known contact with rodents.

Taking advantage of this opportunity, the minister reassured the public that public health measures are underway. He also reminded people of the behaviours that will help avoid becoming infected. This involves washing hands regularly with soap and water; avoiding contact with stool, sperm, urine, saliva, vomit, and contaminated objects from a person suspected to be ill or dead from Lassa; and protecting food and keeping it in a safe place, out of reach of rodents.

It should be recalled that 7 cases have been recorded since the beginning of the epidemic to date, including 5 positive cases.

=======================

[One case is located in Cotonou on the Benin coast and apparently was locally acquired, perhaps from contact with the rodent host or its excrement. The location of the other 3 cases is not mentioned, but a 13 Dec 2018 report indicated that there were 3 cases in the municipality of Parakou in Borgou Department, in the northern part of Benin. Perhaps these 3 cases, which came from the village Taberou (in Nigeria), located 5 km [3.1 mi] from Tandou in the commune of Tchaourou, are the ones mentioned in this report.

The previous Lassa fever cases in Benin this year [2018] occurred in January and also involved case importation from Nigeria. A previous WHO report stated that Lassa fever is endemic in bordering Nigeria, and, given the frequent population movements between Nigeria and Benin, the occurrence of additional cases is not unexpected. Strengthening of cross-border collaboration and information exchange between the 2 countries is, therefore, needed. - ProMED Mod.TY]

[Images of the rodent reservoirs of Lassa fever virus can be seen as follows:

Government in Benin bans strikes in defence and health and justice sectors
Strikes Benin
- 2 years ago

Date: Fri, 29 Jun 2018 13:37:32 +0200

Cotonou, June 29, 2018 (AFP) - Benin's Constitutional Court has banned the right to strike by workers in the country's defence, security, justice and health sectors, sparking concern among union officials and legal observers. The ruling, issued late on Thursday, came after months of wrangling between the government and the court, which had previously said the measure was unconstitutional.

"Civil servants, public security forces and equivalents should fulfil their duties in all circumstances and not exercise their right to strike," the court said in its new ruling. "There should be no disruption to the duties of public sector defence, security, justice and health workers." The decision was taken "in the public interest" and for "the protection of citizens", it said.

Speaking on Friday, one senior union leader, who asked to remain anonymous, described the ruling as shocking and a "hammer blow". And Benin legal affairs expert Albert Medagbe told AFP the decision was a "worrying sudden legal U-turn". Earlier this month, a close ally of President Patrice Talon, Joseph Djogbenou, was elected to lead the Constitutional Court during a vote held behind closed doors. Djogbenou is Talon's former personal lawyer and was previously Benin's attorney general.

Until his arrival, the court had strained relations with Talon, and had criticised the government for misunderstanding and failing to respect the constitution. The small West African nation was last year hit by a wave of public sector strikes, which brought the education, health and justice system to a near halt. The industrial action was sparked by Talon's attempts to introduce free-market reforms.

Cotonou, Feb 21, 2018 (AFP) - Nine people appeared in a Benin court Wednesday on charges of selling fake drugs at the start of a landmark trial in a regional campaign against illicit medicines. The suspects, who include executives from major pharmaceutical companies operating in the West African nation, were remanded in custody until March 6 on technical grounds. They are accused of "the sale of falsified medicines, (and) display, possession with a view to selling, commercialisation or sale of falsified medical substances." A tenth defendant, the head of the Directorate for Pharmacies, Medications and Diagnostic Evaluation (DPMED) under the control of the ministry of health, was not in court on the trial's opening day. He is accused of failing to prevent the offences.

Benin launched the crackdown last year after mounting alarm about the scale of the trafficking of expired and counterfeit drugs in West Africa. Fake medicines are drugs that are bogus or below regulatory standards but often are outwardly indistinguishable from the genuine product. Taking them may do nothing to tackle an illness or -- in the case of antibiotics -- worsen the problem of microbial resistance. According to an investigation by the Paris-based International Institute of Research Against Counterfeit Medicines (IRACM), West African markets are awash with fake drugs made in China and India.

In 2015, the American Society of Tropical Medicine and Hygiene estimated that 122,000 children under five died due to taking poor-quality antimalarial drugs in sub-Saharan Africa. A 15-nation regional body, the Economic Community of West African States (ECOWAS), last April announced an investigation into the fake drugs business. A lawyer for the civilian plaintiffs told AFP that the trial in Benin was adjourned until March 6 at their request "in order to incorporate another case, of illegal pharmaceutical practice".

Algeria

Algeria US Consular Information SheetMay 08, 2008 COUNTRY DESCRIPTION:Algeria is the second-largest country in Africa, with over four-fifths of its territory covered by the Sahara desert.The country has a population of 35 million p
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ople mainly located near the northern coast.Algeria is a multi-party, constitutional republic.Facilities for travelers are available in populated areas, but sometimes limited in quality and quantity.Read the Department of State Background Notes on Algeria for additional information.

ENTRY/EXIT REQUIREMENTS:Passports and visas are required for U.S. citizens traveling to Algeria.The Algerian visa application must be typed.The Algerian Embassy no longer accepts handwritten visa applications.For further information on entry/exit requirements, travelers may contact the Embassy of the People's Democratic Republic of Algeria at 2137 Wyoming Avenue NW, Washington, DC 20008, telephone (202) 265-2800.Visit the Embassy of the People's Democratic Republic of Algeria web site at http://www.algeria-us.org for the most current visa information. Information about dual nationality or the prevention of international child abduction can be found on our web site.For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY: Although no Americans are known to have been killed by terrorists in Algeria, more than 120 foreigners were murdered at the height of the terrorism threat in Algeria in the 1990s.In response to the terrorist threat, the U.S. government substantially reduced the number of U.S. Government personnel in Algeria during the 1990s.Small-scale terrorist activities, including bombings, false roadblocks, kidnappings, ambushes, and assassinations, occur regularly.Since early 2007, vehicle-borne suicide bomb attacks have emerged as a terrorist tactic in Algeria, including in the capital.Suicide car bomb attacks in December 2007 targeted the UN Headquarters and the Algerian Constitutional Council in Algiers.The attacks occurred in areas where many diplomatic missions and residences are located.The group that claimed credit for the December attacks has pledged more attacks against foreign targets, and specifically American targets.

The Travel Warning for Algeria contains the most current information concerning the threat from terrorism. Currently, Embassy staffing is at full capacity and the Embassy is able to provide full services. U.S. Government employees traveling between cities must be accompanied by a security escort.U.S. citizens should also carefully consider the security risks involved when using public transportation such as buses and taxis.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affair’s web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll line at 1-202-501-4444.These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.

CRIME:The crime rate in Algeria is moderately high and increasing.Serious crimes have been reported in which armed men posing as police officers have entered homes and robbed the occupants at gunpoint.False roadblocks/checkpoints have been employed to rob motorists (see Traffic Safety and Road Conditions section below).Some of these incidents resulted in the murder of the vehicles' occupants; there has been an increase in the kidnapping of vehicle occupants who appear to be wealthy.Petty theft and home burglary occur frequently, and muggings are on the rise, especially after dark in the cities.Theft of contents and parts from parked cars, pick-pocketing, theft on trains and buses, theft of items left in hotel rooms and purse snatching are common.Alarms, grills, and/or guards help to protect most foreigners' residences.

In many countries around the world, counterfeit and pirated goods are widely available. Transactions involving such products may be illegal under local law.In addition, bringing them back to the United States may result in forfeitures and/or fines.More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.

INFORMATION FOR VICTIMS OF CRIME:The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds could be transferred.Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.

See our information on Victims of Crime.

MEDICAL FACILITIES AND HEALTH INFORMATION:Hospitals and clinics in Algeria are available and improving in the large urban centers, but are still not up to Western standards. Doctors and hospitals often expect immediate cash payment for services.Most medical practitioners speak French; English is not widely used. Prescription medicines are not always readily available.Some pharmacies may at times be out-of-stock.In addition, the medicine may be sold under a different brand name and may contain a different dosage than in the U.S.Please be aware that some newer medications may not yet be available in Algeria.It is usually easy to obtain over-the-counter products. Emergency services are satisfactory, but response time is often unpredictable.In all cases, response time is not as fast as in the U.S.

Cases of tuberculosis are regularly reported, but do not reach endemic levels.Every summer, public health authorities report limited occurrences of water-borne diseases, such as typhoid.In addition, HIV/AIDS is a concern in the remote southern part of the country, especially in border towns.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control (CDC) and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.Further health information for travelers is available at http://www.who.int/ith/en .

MEDICAL INSURANCE:The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.The information below concerning Algeria is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

Algerian roads are overcrowded and traffic-related accidents kill a large number of people every year.Drivers will encounter police and military checkpoints on major roads within and on the periphery of Algiers and other major cities.Security personnel at these checkpoints expect full cooperation.Motorists should be aware that terrorists employ false roadblocks as a tactic for ambushes and kidnappings, primarily in the central regions of Boumerdes and Tizi Ouzou and some parts of eastern Algeria (see Crime section above).

Please refer to our Road Safety page for more information.Visit the website of the national authority responsible for road safety at http://www.ministere-transports.gov.dz/ .

AVIATION SAFETY OVERSIGHT:As there is no direct commercial air service to the United States by carriers registered in Algeria, the U.S. Federal Aviation Administration (FAA) has not assessed Algeria’s Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards.For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa.

SPECIAL CIRCUMSTANCES:Algeria maintains restrictions on the import and export of local currency.Foreign currency must be exchanged only at banks or authorized currency exchange locations, such as major hotels.Photography of military and government installations is prohibited.It is also illegal to import weapons, body armor, handcuffs or binoculars.Please see our Customs Information.

PROSELYTIZING:Islam is the state religion of Algeria.The Algerian government allows non-Muslim religious worship only in structures exclusively intended and approved for that purpose. Activities such as proselytizing, engaging in activities which the Algerian authorities could view as encouraging conversion to another faith, and convening religious ceremonies in private residences are prohibited under a March 2006 law.

CRIMINAL PENALTIES:While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.Penalties for breaking the law can be more severe than in the United States for similar offenses.Persons violating Algerian laws, even unknowingly, may be expelled, arrested or imprisoned.Penalties for possession, use, or trafficking in illegal drugs in Algeria are severe, and convicted offenders can expect long jail sentences and heavy fines.Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.Please see our information on Criminal Penalties.

REGISTRATION / EMBASSY LOCATION:Americans living or traveling in Algeria are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration web site, and to obtain updated information on travel and security within Algeria.Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.The U.S. Embassy is located at 5 Chemin Cheikh Bachir El-Ibrahimi, B.P. 408 (Alger-gare) 16000, in the capital city of Algiers.The telephone number is [213] 770-08-20-00 which can also be reached after hours.The fax number is [213] 21-9822-99.The U.S. Embassy work week is Saturday through Wednesday.* * * * * *This replaces the Country Specific Information dated March 26, 2008, to update the section on Crime.

Algiers, Feb 25, 2020 (AFP) - Algerian authorities on Tuesday announced the country's first case of the novel coronavirus, in an Italian citizen who arrived in the country on February 17. "One case was confirmed positive for coronavirus (COVID-19), out of two suspected cases (both) of Italian nationality," the North African country's health ministry said. State television said the infected person had been placed in isolation, without offering further details. The health ministry said it had reinforced its "monitoring and surveillance systems at all points of entry" into Algeria.

Paris, Sept 9, 2019 (AFP) - Some 13,000 passengers, mainly booked on flights to and from Algeria, are still stranded after France's second-largest airline Aigle Azur went into receivership, a senior French official said Monday, adding that several potential buyers had been identified. The airline, which employs almost 1,200 staff, filed for bankruptcy and suspended flights last week after losses which prompted a shareholder coup that ousted the chief executive. "Out of 19,000 passengers who found themselves in difficulty at the peak of the crisis, there are still 13,000" who have yet to be repatriated, the secretary of state for transport, Jean-Baptiste Djebbari, told the Le Parisien daily.

He said these included 11,000 passengers booked on flights into and out of Algeria, 600 on Mali flights as well as other destinations ranging from Russia to Lebanon. Air France chartered two special flights on Saturday and then again on Sunday to help passengers booked on Algeria flights, which flew out one quarter full but were full on the return. "The hardest moment of the crisis will be over before the end of the week. At least half the passengers (affected) will have been repatriated," Djebbari said.

The airline transported last year some 1.9 million passengers, with destinations in Algeria making up half of its operations that brought in 300 million euros ($329 million) of revenue. "There needs to be a serious buyer who is capable of offering guarantees for a maximum number of employees. The good news is that many (potential buyers) have expressed interest," said Djebbari.

He said the former chief executive of Air France's subsidiary Hop!, Lionel Guerin, was among interested parties, backed by a team of aviation professionals with financial support. He added that Air France itself also appeared interested in making an offer. "This shows there is still an interest in Aigle Azur," he added. Neither party has so far publicly confirmed an interest, with Air France declining to comment on an "evolving" situation.

According to union officials, Air France could be interested in the medium-haul routes to Algeria and the Dubreuil group, the majority shareholder in Air Caraibes, the long haul routes to destinations like Brazil and Mali. The largest shareholder in Aigle Azur is the Chinese conglomerate HNA Group, which owns Hainan Airlines, with a 49-percent stake. David Neeleman, an American airline entrepreneur whose companies include JetBlue and TAP Air Portugal, owns 32 percent, and French businessman Gerard Houa owns 19 percent.

The current human brucellosis epidemic in Ath Mansour has again claimed new victims. These are 2 citizens of Ath Vouali, hospitalized Wednesday [28 Aug 2019] at the EPH Kaci Yahia M'Chedallah. The affected subjects are a 40-year-old father and his 15-month-old son. Met in the halls of the hospital, the father indicated that he and his family have consumed raw milk from the farmer whose goats were infected almost 2 months ago.

After these 2 new victims, 6 cases of human brucellosis have been detected since last week [18-24 Aug 2019] in this commune and hospitalized at M'Chedallah hospital. In this context, we learned that a Daira commission, composed of a member of the APC executive of Ath Mansour, the subdivisionary of agriculture of Ahnif, a member of the prevention of the Ahnif EPSP and the M'Chedallah Civil Protection Unit, was set up on the instructions of the Daira Chief.

This commission has already visited the premises where the goat farmer in question resides, in Rodha, south of the capital of the commune, to make the necessary arrangements, such as the census of the animals and their quarantine (isolation) with slaughter orientation on those carrying this disease. It should be remembered that caprine brucellosis was detected by an animal health practitioner at the farm level in June 2019 and that part of the herd was already slaughtered at the municipal slaughterhouse.

A total of 75 goats were slaughtered out of 300 heads, with carcass burial as stipulated by the regulations in force. "The transmission of this epidemic was made from the consumption of milk that the farmer of the contaminated livestock sold to a merchant of this commune. This product, raw or curd, was then sold retail to customers. It should be noted that the brucellosis virus has an incubation period that can last several months before the 1st symptoms, which are fever and nausea followed by a general weakness, begin to appear. The treatment is also spread over a long period of time," says a medical source who expects more cases to be detected in the coming days.

Distraught, the citizens of Ath Mansour storm the health institutions of the region where samples are taken for the purposes of screening. A source close to the agricultural services says that none of the citizens hitherto infected by this bacterium has goats. [Byline: Oulaid Soualah]

==========================

[This infection, a bacterial zoonosis, is classified among the category B biowarfare agents. Natural transmission to humans occurs after occupational exposure or through ingestion of contaminated food products. Although brucellosis has become a rare entity in the USA and many industrialized nations because of animal vaccination programs, this condition remains a significant health problem in many developing countries.

Each species of _Brucella_ has a specific animal reservoir in which chronic disease is present. The bacilli tend to localize in the reproductive organs of the animals, causing sterility and abortions, and are shed in large numbers in the animal's urine, milk, and placental fluid. This localization allows for efficient spread to farmers, veterinarians, slaughterhouse workers, and consumers.

Among the 4 species known to cause disease in humans, _Brucella melitensis_ (from goats, sheep, or camels) may be the most virulent, producing the most severe and acute cases of brucellosis with disabling complications. A prolonged course of illness, which may be associated with suppurative destructive lesions, is associated with _B. suis_ (from feral or commercially raised pigs) infection. _B. abortus_ (from cattle, buffalo, and camels) is associated with mild-to-moderate sporadic disease that is rarely associated with complications. - ProMED Mod.LL]

A total of 3 cases of brucellosis, known as "Malta fever", a disease that affects farm animals, were recorded at Ksar-Chellala, in the far east of the Tiaret wilaya (province). These are 3 women who consumed curd in the last days of Ramadan, according to doctors at the local hospital. In all, more than 150 cases of brucellosis in humans have been recorded since the beginning of 2019.

According to the Department of Health and Population (DSP), the wilaya of Tiaret has recorded 154 cases of brucellosis in humans in 25 municipalities since the beginning of 2019. Due mainly to the consumption of dairy products and unpasteurized derivatives, cases of brucellosis have been recurrent in the wilaya of Tiaret for several years. Blood samples from cattle and goats were collected as part of an epidemiological survey, in collaboration with the Mostaganem Regional Veterinary Laboratory, which has already confirmed cases of brucellosis in localities in the eastern part of the country in wilayat such as Zmalet Emir Aek and Ksar Chellala.

However, the services concerned, starting with the veterinary inspection of wilaya, have always warned against the consumption of natural raw milk without boiling or direct contact with the infected animal. [Byline: El-Houari Dilmi]

=========================

[This infection, a bacterial zoonosis, is classified among the category B biowarfare agents. Natural transmission to humans occurs after occupational exposure or through ingestion of contaminated food products. Although brucellosis has become a rare entity in the United States and many industrialized nations because of animal vaccination programs, this condition remains a significant health problem in many developing countries.

Each species of _Brucella_ has a specific animal reservoir in which chronic disease is present. The bacilli tend to localize in the reproductive organs of the animals, causing sterility and abortions, and are shed in large numbers in the animal's urine, milk, and placental fluid. This localization allows for efficient spread to farmers, veterinarians, slaughterhouse workers, and consumers.

Among the 4 species known to cause disease in humans, _Brucella melitensis_ (from goats, sheep, or camels) may be the most virulent, producing the most severe and acute cases of brucellosis with disabling complications. A prolonged course of illness, which may be associated with suppurative destructive lesions, is associated with _B. suis_ (from feral or commercially raised pigs) infection. _B. abortus_ (from cattle, buffalo, and camels) is associated with mild-to-moderate sporadic disease that is rarely associated with complications.

In the Maghreb and the Middle East, human brucellosis is usually contracted through consumption of raw goat/ewe's milk or local artisanal cheese made from raw milk, and _Brucella melitensis_ is responsible for the great majority of the reported cases, with a marked predominance of its biovar 3, as in other Mediterranean countries. - ProMED Mod.LL]

Japan

General***************************Japan is a highly developed country with excellent tourist facilities. The country covers a number of islands and the population is estimated at over 125 million. English is widely spoken in the main tourist a
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d urbanised centres. Weather Profile***************************Due to the strong influence from the sea, Japan tends to have a high rainfall but milder winters than the adjacent mainland of China. This is similar to the climate experienced in Ireland by comparison to the rest of Europe. Spring and Autumn are usually the most pleasant months but during the Summer the climate can be significantly humid and tiring. During this time it will be essential that fluid intake is increased and that salt (lost through perspiration) is replaced - usually by increasing the amount eaten on your food providing this is not contraindicated by any personal medical condition such as blood pressure etc. Alcohol Consumption***************************The Japanese authorities have limited patience with those arrested while under the influence of alcohol. For some travellers visiting the country this may mean a prolonged stay in the local jail and the subsequent missing of important appointments. Natural Disasters***************************Japan is situated in a region of the world which regularly experiences earthquakes and other climatic changes including typhoons. A number of relatively small earthquakes are reported each year but, to date, this has seldom affected any tourist itinerary. However, further information is available at http://www.tokyoacs.com Safety and Security***************************The risk to personal security for tourists while travelling throughout Japan is small though commonsense care of personal belongings is always essential. Where available, use the hotel safety boxes to store valuables and your passport, return air tickets. During the mid 1990’s a number of terrorist incidents occurred but no recent serious problems are being reported. Airport Taxes***************************Many countries now include the cost of their ‘departure tax’ within the ticket. In Japan this will depend on which airport you leave from. The fee is collected in Yen at Kansai - Osaka International Airport but usually included in the ticket cost if flying via Narita - Tokyo International Airport. Cost of living***************************Japan is not a cheap country for tourists. The cost of living is one of the highest throughout the world. Credit cards may be used in main cities but the ATM’s machines may not be available at all hours. Before taking a taxi from the airport it would be wise to check the costs and then assess whether or not it might be more prudent to use the local bus transport! Medical Care***************************The level of medical care throughout most tourist regions in Japan is excellent. However, there may be limited English-speaking doctors in some more rural areas and even where this facility is available in the main cities the cost of healthcare can be very expensive. It is wise to carefully check your travel health insurance premium before you leave home. Local Medications***************************Some commonly used European over-the-counter medicationsmay not be available in Japan. Also, there are strict laws governing the importation of certain medications which can be strictly enforced. Certain inhalers, sinus preparations etc may be confiscated on arrival. If you are taking any personal medications it may be wise to check before you leave. Obviously never carry packages for anybody else while travelling unless you are certain of the contents. Avoiding Prickly Heat***************************The term prickly heat is used in a variety of ways but the cause is generally the same. In a hot climate the body perspires to maintain the internal temperature at a correct level. In the perspiration there will be fluid and your personal salts. The fluid evaporates but the salt dries against the skin. It is your individual reaction to this salt that leads to the ‘prickly heat rash’. The reaction to these salts can be minimised by removing the salts from the skin surface as soon as possible. Change your clothes regularly, use plenty of talcum powder to absorb the perspiration and dry off well after showering. Food & Water Care in Japan***************************Any international traveller should recognise the risks of a ruined trip from unwise indulgence in local food and beverages. In Japan the level of food hygiene is high but the consumption of Sushi (uncooked raw fish) is unwise. Bivalve shellfish also carry a significant risk due to the limited level of sterilisation during the cooking process. Malaria & Mosquitoes***************************No malaria transmission occurs throughout Japan although avoiding mosquito bites during the humid months is wise. Airborne Disease***************************In any situation where you will be crowded together with many others the risk of a variety of airborne diseases will be higher. This will include serious diseases such as Meningococcal Meningitis but also others such as Influenza and the common cold. The risk of Meningococcal Meningitis in Japan is regarded as small and vaccine is not routinely recommended. However, having the Flu vaccine may be a wise precaution. It is also sensible to carry a small supply of lozenges to treat the inevitable sore throat which may occur. Driving in Japan***************************The road system throughout Japan is excellent but unfortunately the road signs may prove too much of a hurdle for those unfamiliar with the language! The congestion within the cities tends to be high and tolls on some of the major roads may be quite expensive. The traffic moves on the left side of the road but for many tourists it will be wiser to consider using local transportation rather than risking a ruined holiday. English Help Lines***************************Tourists can obtain important information and assistance in English while visiting Japan through the following numbers;In Tokyo - 03-3968 4099Rest of Japan - 0120-461 997 Vaccines for Japan***************************For the majority of short-term travellers visiting Japan no particular vaccines will be recommended. Those planning to live for longer periods within the country will need to discuss this through in greater detail.

Tokyo, May 1, 2020 (AFP) - Japan's Prime Minister Shinzo Abe said Friday the government would plan for an approximately month-long extension of a state of emergency declared over the coronavirus pandemic. Abe put in place an initial month-long state of emergency for seven regions on April 7, later expanding it to cover the entire country. But with the measures due to expire on May 6, Abe said he had instructed his minister for the virus outbreak Yasutoshi Nishimura to plan for an extension. "After receiving this report from the panel of experts, I asked Minister Nishimura to use extending the current framework of the state of emergency by about one month as the base scenario for swiftly drafting plans that will fit the needs of the regions," Abe said.

An expert panel advising the government is reviewing the situation in different parts of the country, he added. "We will listen to their opinions and we hope to make a decision on May 4th." Abe said Japan had so far managed to avoid the sharp increase in infections seen in some other parts of the world, but cautioned that vigilance was still needed. "The view of experts is that we will continue to need cooperation of the Japanese people for the foreseeable future."

An extension of the state of emergency had been widely expected, despite the comparatively small scale of the outbreak in Japan, with nearly 14,300 infections recorded and 432 deaths so far. The state of emergency is significantly less restrictive than measures seen in parts of Europe and the United States. It allows governors to urge people stay at home and call on businesses to stay shut. But officials cannot compel citizens to comply, and there are no punishments for those who fail to do so. Despite the relatively small scale of Japan's outbreak, there have been persistent fears about a spike in infections that could quickly overwhelm the country's healthcare system.

Doctors' associations have warned that hospitals are already stretched thin, with officials in Osaka even calling for donations of raincoats to serve as protective equipment for health workers stuck using trash bags. Measures have been implemented to try to ease the pressure, including sending coronavirus patients with mild symptoms to hotels for quarantine, rather than keeping them in overcrowded hospitals. The government has also said it is increasing testing capacity, but continues to face criticism for the relatively low numbers of tests being carried out, in part because of stringent criteria.

Tokyo, April 20, 2020 (AFP) - Japanese medics are warning more must be done to prevent the coronavirus from overwhelming the country's healthcare system as confirmed cases passed 10,000, despite a nationwide state of emergency. Experts have been alarmed by a recent spike in COVID-19 infections, with hundreds detected daily.

Japan's outbreak remains less severe than in hard-hit European countries, but its caseload is one of Asia's highest after China and India, and is roughly on par with South Korea. There have been 171 deaths recorded so far in Japan and 10,751 cases, with the country under a month-long state of emergency, initially covering seven regions but now in place nationwide.

Prime Minister Shinzo Abe has urged residents to reduce contact with other people by 70 to 80 percent, and the number of people on Tokyo's normally packed transport system has dropped significantly. But the measures do not prevent people from going out, and many shops and even restaurants remain open, even as medical associations warn the country's healthcare system is struggling to cope. "The system is on the verge of collapse in many places in Japan," said Kentaro Iwata, an infectious diseases specialist from Kobe University who has repeatedly criticised the government's response to the crisis.

Speaking at a press briefing on Monday, Iwata said Japan's strategy of limited testing and intensive contact-tracing worked well in the initial phase of the local outbreak, when numbers were small. But he charged that Japan failed to adapt as the outbreak grew. "We needed to prepare for once the situation changes, once the cluster-chasing became not effective and we needed to change strategy immediately," he said. "But traditionally speaking, and historically speaking, Japan is not very good at changing strategy," he added. "We are very poor at even thinking of plan B because thinking of plan B is a sign of admitting failure of plan A."

- Not a 'worst-case scenario' -Japan's government argues it has adjusted its strategy, boosting testing capacity, changing rules that required all positive cases to remain in hospitals where wards quickly became full, and imposing the state of emergency to reduce the spread. But medical experts have called the measures insufficient. "Beds for novel coronavirus patients continue to be almost full," Haruo Ozaki, president of the Tokyo Medical Association, warned last week. The association has been increasing beds but with a large number of new cases coming in every day, "beds are being occupied instantly," he said.

The health minister has acknowledged that hospitals have in some cases turned away suspected coronavirus patients in ambulances. "Japan hasn't built a system in which ordinary hospitals can take infectious disease patients in an emergency, when designated hospitals can't cope," Ozaki said on Friday. "We are doing our best... but infections are spreading faster than expected," he added. And hospitals are also struggling with equipment shortages, with the mayor of Osaka calling for donations of unused raincoats for health workers currently forced to use garbage bags for protective equipment.

Both Iwata and Ozaki warned that the state of emergency now in place until at least May 6 was not sufficient. "While they talk about border controls and decreasing person-to-person contacts, they let stores stay open," Ozaki complained. Iwata said he was "half-encouraged and half-discouraged" by the infection numbers in Tokyo, which he called "relatively stable." "My biggest fear was the explosion of diagnoses... like in New York City, which didn't happen," he said. "These numbers are much better than the worst-case scenario."

Tokyo, April 19, 2020 (AFP) - A 6.4-magnitude earthquake struck off the east coast of Japan early Monday, according to the US Geological Survey, but no tsunami warning was issued. The epicentre of the earthquake was 41.7 kilometres (26 miles) beneath the Pacific seabed, less than 50 kilometres off the coast of Miyagi prefecture, the USGS said on its website, rating the risk of casualties and damage as low.

The Japan Meteorological Agency (JMA) put the quake at a magnitude of 6.1 and a depth of 50 kilometres. Japan's Kyodo News Agency said no tsunami warning had been issued after the tremor, which hit just after 5.30 am (2030 GMT). Japan sits on the Pacific "Ring of Fire", an arc of intense seismic activity that stretches through Southeast Asia and across the Pacific basin. In 2011, a devastating 9.0 magnitude earthquake struck roughly 130 kilometres east of Miyagi prefecture, unleashing an enormous tsunami, triggering the Fukushima nuclear reactor meltdown and killing nearly 16,000 people.

Tokyo, April 16, 2020 (AFP) - Japan's government will convene a key panel of medics Thursday to advise on its state of emergency over the coronavirus, as local media reported the prime minister would expand the measures to cover the entire country. Shinzo Abe has already declared a month-long state of emergency in seven regions, including Tokyo. People in these places are being urged to stay inside but the rules stop far short of the tight lockdowns seen in other parts of the world.

Since the emergency came into effect on April 8, several regional governors have called for the measures to be expanded to cover their areas -- warning of a growing number of coronavirus infections and overwhelmed medical facilities. Some have declared their own local emergencies, even though they carry no legal force. "Today, an advisory committee will be held. We should listen to the opinions of experts about areas subject to a state of emergency," government spokesman Yoshihide Suga told reporters at a regular afternoon briefing. "If we limit areas (under the state of emergency), people are increasingly flowing to neighbouring ones. We have to deal with it while discussing what to do during the holidays," he added, referring to the Golden Week period in late April and early May, when much of the country travels.

Japan has so far seen a relatively small outbreak of the virus, despite recording its first case in mid-January, with around 8,500 infections and 136 deaths by Thursday. But local medical associations and experts have sounded the alarm, and Abe has asked people in areas already under a state of emergency to reduce contact with others by 70 to 80 percent to avoid an explosive growth in infections. The state of emergency allows governors to ask people to stay indoors and request that businesses close, but there are no enforcement mechanisms and no penalties for those who fail to comply.

In Tokyo, the governor has called on people to work from home, and significant drops have been seen in the number of people commuting each day on the city's notoriously crowded transport system. But while some central areas have been uncharacteristically deserted, local neighbourhoods have remained relatively bustling, raising concerns about whether the measures will be sufficient. Japan's two emergency medical associations this week issued a joint statement warning they are "already sensing the collapse of the emergency medical system," with hospitals unable to deal with patients suffering from non-coronavirus ailments. And in Japan's third-biggest city Osaka, the mayor has appealed for donations of raincoats to serve as personal protection for health workers who he said were being forced to resort to garbage bags.

Tokyo, April 7, 2020 (AFP) - Japan on Tuesday declared a state of emergency over a spike in coronavirus cases, ramping up efforts to contain infections but stopping short of the strict lockdowns seen in other parts of the world. The government has come under mounting pressure to tackle an outbreak that remains small by global standards but has raised concerns among Japanese medical experts, with warnings that local healthcare systems are already overstretched. "As I decided that a situation feared to gravely affect people's lives and the economy has occurred... I am declaring a state of emergency," Abe said. The move allows governors in seven affected regions including Tokyo to ask people to stay indoors and request businesses close.

But many supermarkets and other shops will stay open, transport will continue to run and there are neither enforcement mechanisms nor penalties laid out for those who fail to comply with government requests. "Although a state of emergency is declared, it won't mean a city lockdown as seen overseas," Abe said. "We will prevent the spread of infection while maintaining economic and social services such as public transport as much as possible." Pressure to declare an emergency had increased after Tokyo reported several days of record infections, with 143 new cases logged on Sunday.

Tokyo Governor Yuriko Koike has already asked residents of the capital to avoid unnecessary outings and work from home, but had pushed for an emergency declaration to give her requests legal strength. Seven regions are covered by the month-long declaration: Tokyo, neighbouring Chiba, Kanagawa and Saitama, the western hub of Osaka and neighbouring Hyogo, and the southwestern region of Fukuoka. The measure will last through to the end of the Golden Week holiday period, when much of the country travels in a rare break.

- 'Lives at stake' -"It may cause inconvenience in daily life, but I call for everyone's cooperation because lives are at stake," Koike told reporters earlier. The measure also allows governors to commandeer property for medical purposes and close public facilities like schools, many of which have already shut down. The economic impacts of the measure and the broader global pandemic have raised concern of a recession in Japan, and Abe on Monday unveiled plans for a stimulus package worth around $1 trillion, or 20 percent of gross domestic product.

Japan has so far been spared the sort of virus outbreak seen in parts of Europe and the United States, with close to 4,000 confirmed infections and 80 deaths. But medical experts have repeatedly sounded the alarm in recent weeks, citing the rapid increase of infections in parts of the country. And on Monday, doctors in Tokyo said the situation in the capital was already in "critical condition".

- Public backing -In a bid to ease the pressure, rules requiring people infected with the virus to stay in hospital even if their symptoms are mild have been relaxed, with Koike saying hotels would be designated as quarantine facilities for those in non-serious condition. The government has also pledged to step up testing capacity and the number of beds and ventilators available to treat those in serious condition.

The state of emergency is a relatively relaxed approach to lockdown compared to other parts of the world, a function of Japan's legal system, which restricts the government's ability to limit the movement of citizens. "Japan is still haunted by the negative legacy of the war and the oppression of its citizens," said Yoshinobu Yamamoto, an emeritus professor of international politics at the University of Tokyo. But he warned that there could be calls for stronger measures if the outbreak continues to spread.

Japan saw its first case of the virus in mid-January, and came under heavy criticism for its handling of the coronavirus-wracked Diamond Princess, where an on-board quarantine ended with over 700 people contracting the virus and 11 deaths. In the capital, people expressed support for the state of emergency, with some saying they felt it should have been declared sooner. "When you see on TV what's going on in New York with the cases doubling within three, four days, it really sends chills down my spine," 76-year-old Mitsuo Oshiyama told AFP. "I don't understand why the government waited so long."

El Salvador

El Salvador - US Consular Information SheetMay 01, 2008 COUNTRY DESCRIPTION: El Salvador is a democratic country with a developing economy. Tourism facilities are not fully developed. The capital is San Salvador, accessible by El Salvador's In
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ernational Airport at Comalapa. Both the U.S. Dollar and the Salvadoran Colon are legal tender in El Salvador. While Colones are still accepted, the primary currency of El Salvador is the U.S. Dollar. Americans traveling with U.S. Dollars should not exchange them for Colones. Read the Department of State Background Notes on El Salvador for additional information.

ENTRY/EXIT REQUIREMENTS:To enter the country, U.S. citizens must present a current U.S. passport and either a Salvadoran visa or a one-entry tourist card.The tourist card may be obtained from immigration officials for a ten-dollar fee upon arrival in country.U.S. travelers who plan to remain in El Salvador for more than thirty days can apply in advance for a multiple-entry visa, issued free of charge, from the Embassy of El Salvador in Washington, DC or from a Salvadoran consulate in Boston, Chicago, Dallas, Houston, Las Vegas, Long Island, Los Angeles, Miami, New York City, or San Francisco.Travelers may contact the Embassy of El Salvador at 1400 16th Street NW, Washington, DC20036, tel. (202) 265-9671, 265-9672; fax (202) 232-3763; e-mail: correo@elsalvador.org or visit the Embassy's web site at http://www.elsalvador.org.When applying for a visa, travelers may be asked to present evidence of U.S. employment and adequate finances for their visit at the time of visa application or upon arrival in El Salvador.For passengers departing by air, El Salvador has an exit tax of $32.00 which is usually included in the price of the airline ticket.

Travelers should be aware that El Salvador's entry requirements vary in accordance with agreements the country has with foreign governments.Citizens of several countries in addition to the United States may enter El Salvador with a current passport and either a visa or tourist card.Citizens of many other countries, including many Latin American and western European nations, may enter with only a current passport.However, citizens of most nations are required to present both a current passport and a visa to enter El Salvador.Non-U.S. citizen travelers are advised to contact a Salvadoran embassy or consulate to determine the entry requirements applicable to them.

In June 2006, El Salvador entered into the “Central America-4 (CA-4) Border Control Agreement” with Guatemala, Honduras, and Nicaragua.Under the terms of the agreement, citizens of the four countries may travel freely across land borders from one of the countries to any of the others without completing entry and exit formalities at immigration checkpoints.U.S. citizens and other eligible foreign nationals, who legally enter any of the four countries, may similarly travel among the four without obtaining additional visas or tourist entry permits for the other three countries.Immigration officials at the first port of entry determine the length of stay, up to a maximum period of 90 days.Foreign tourists who wish to remain in the four-country region beyond the period initially granted for their visit must request a one-time extension of stay from local immigration authorities in the country where the traveler is physically present, or they must leave the CA-4 countries and reapply for admission to the region.Foreigners “expelled” from any of the four countries are excluded from the entire CA-4 region.In isolated cases, the lack of clarity in the implementing details of the CA-4 Border Control Agreement has caused temporary inconvenience to some travelers and has resulted in others being fined more than one hundred dollars or detained in custody for 72 hours or longer.

Airlines operating out of El Salvador International Airport require all U.S. citizen passengers boarding flights for the United States (including U.S.-Salvadoran dual nationals) to have a current U.S. passport.U.S. citizens applying for passports at the U.S. Embassy in San Salvador are reminded that proof of citizenship and identity are required before a passport can be issued.Photographic proof of identity is especially important for young children because of the high incidence of fraud involving children.Since non-emergency passports are printed in the United States, and not at the U.S. Embassy in El Salvador, citizens submitting applications in El Salvador should be prepared to wait approximately one week for receipt of their new passports.

The U.S. Embassy in El Salvador reminds U.S. citizen travelers that their activities in El Salvador are governed by Salvadoran law and the type of visa they are issued.Under Salvadoran law, all foreigners who participate directly or indirectly in the internal political affairs of the country (i.e. political rallies, protests) lose the right to remain in El Salvador, regardless of visa status or residency in El Salvador.

Visit the Embassy of El Salvador’s web site at http://www.elsalvador.orgfor the most current visa information.

Information about dual nationality or the prevention of international child abduction can be found on our Consular Affairs web site.For further information about customs regulations, please read our Customs Information sheet.

In an effort to prevent international child abduction, many governments have initiated procedures at entry/exit points.These often include requiring documentary evidence of relationship and permission for the child's travel from the parent(s) or legal guardian if not present.Having such documentation on hand, even if not required, may facilitate entry/departure.Minors traveling on Salvadoran passports and who are traveling alone, with one parent or with a third party must have the written permission of the absent parent(s) or legal guardian to depart El Salvador.A Salvadoran notary must notarize this document.If the absent parent(s) or legal guardian is (are) outside of El Salvador, the document must be notarized by a Salvadoran consul.If a court decree gives custody of the child traveling on a Salvadoran passport to one parent, the decree and a passport will allow the custodial parent to depart El Salvador with the child.Although Salvadoran officials generally do not require written permission for non-Salvadoran minors traveling on U.S. or other non-Salvadoran passports, it would be prudent for the parents of minor children traveling on U.S. passports to provide similar documentation if both parents are not traveling with their children.

SAFETY AND SECURITY: Most travelers to El Salvador experience no safety or security problems, but the criminal threat in El Salvador is critical.Random and organized violent crime is endemic throughout El Salvador.U.S. citizens have not been singled out by reason of their nationality, but are subject to the same threat as all other persons in El Salvador.See the section below on Crime for additional related information. Political or economic issues in the country may give rise to demonstrations, sit-ins or protests at any time or place, but these activities occur most frequently in the capital or on its main access roads.U.S. citizens are cautioned to avoid areas where demonstrations are being held and to follow local news media reports or call the U.S. Embassy for up-to-date information.Information about demonstrations also is available as “Security Alerts” on the U.S. Embassy home page at http://elsalvador.usembassy.gov. Many Salvadorans are armed, and shootouts are not uncommon.Foreigners, however, may not carry guns even for their own protection without first obtaining a firearms license from the Salvadoran government.Failure to do so will result in the detention of the bearer and confiscation of the firearm, even if it is licensed in the United States. Armed holdups of vehicles traveling on El Salvador's roads are increasing, and U.S. citizens have been victims in various incidents.In one robbery, an American family was stopped by gunmen while driving during the day on the Pan American highway in the Santa Ana Department.In another incident, an American citizen passenger was robbed after the van in which she was riding was carjacked by armed men.The van was stopped at a traffic light on the busy road between Comalapa International Airport and San Salvador shortly after dark. Strong undertows and currents can make swimming at El Salvador's Pacific Coastal beaches extremely dangerous for even strong and experienced swimmers.As an example of this hazard, during a single seven-day holiday period, nine Salvadoran citizens drowned while swimming at Pacific beaches.In one month alone, three U.S. citizens drowned while swimming at Pacific beaches in La Libertad and La Paz Departments.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S., or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad. CRIME: The U.S. Embassy considers El Salvador a critical crime-threat country.The homicide rate in the country increased 25 percent from 2004 to 2007, and El Salvador has one of the highest homicide rates in the world.Violent crimes, as well as petty crimes are prevalent throughout El Salvador, and U.S. citizens have been among the victims. The Embassy is also aware that there has been at least one rape of an American minor and one attempted rape of an American adult in the past year.Travelers should avoid displaying or carrying valuables in public places.Passports and other important documents should not be left in private vehicles.Armed assaults and carjacking take place both in San Salvador and in the interior of the country, but are especially frequent on roads outside the capital where police patrols are scarce.Criminals have been known to follow travelers from the international airport to private residences or secluded stretches of road where they carry out assaults and robberies.Armed robbers are known to shoot if the vehicle does not come to a stop.Criminals often become violent quickly, especially when victims fail to cooperate immediately in surrendering valuables.Frequently, victims who argue with assailants or refuse to give up their valuables are shot.Kidnapping for ransom continues to occur, but has decreased in frequency since 2001.U.S. citizens in El Salvador should exercise caution at all times and practice good personal security procedures throughout their stay. The U.S. Embassy warns its personnel to drive with their doors locked and windows raised, to avoid travel outside of major metropolitan areas after dark, and to avoid travel on unpaved roads at all times because of criminal assaults and lack of police and road service facilities.Travelers with conspicuous amounts of luggage, late-model cars or foreign license plates are particularly vulnerable to crime, even in the capital. Travel on public transportation, especially buses, both within and outside the capital, is risky and not recommended.The Embassy advises official visitors to use radio-dispatched taxis or those stationed in front of major hotels. U.S. citizens using banking services should be vigilant while conducting their financial exchanges either inside local banks or at automated teller machines.There have been several reports of armed robberies in which victims appear to have been followed from the bank after completing their transactions. Visitors to El Salvador should use caution when climbing volcanoes or hiking in other remote locations.Armed robberies of climbers and hikers are common.Mine-removal efforts ceased several years ago, but land mines and unexploded ordnance in backcountry regions still pose a threat to off-road tourists, backpackers, and campers.The Embassy strongly recommends engaging the services of a local guide certified by the national or local tourist authority when hiking in backcountry areas, even when within the national parks. INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Embassy.If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the U.S. Embassy for assistance.The Embassy staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.Although the investigation and prosecution of crime is solely the responsibility of local authorities, consular officers can help you understand the local criminal justice process and find an attorney if needed.

Victims of crime should bear in mind that law enforcement resources are limited and judicial processes are uneven in El Salvador.Many crimes in the country go unsolved and the likelihood for redress through the judicial system is limited.See our information on Victims of Crime. MEDICAL FACILITIES AND HEALTH INFORMATION: There are few private hospitals with an environment that would be acceptable to visiting Americans.The Embassy recommends that these hospitals be used only for emergency care, to stabilize a condition prior to returning to the U.S. for definitive evaluation and treatment.Private hospitals and physicians expect upfront payment (cash or, for hospitals, credit card) for all bills.Priority Ambulance (503-2264-7911) is the only ambulance service in San Salvador that has trained personnel and medical equipment to manage most emergencies.Not all medicines found in the U.S. are available in El Salvador.Medicines often have a different brand name and are frequently more expensive than in the U.S. No specific vaccinations are required for entry into El Salvador from the United States. Travelers coming from countries where yellow fever is endemic must have had a yellow fever vaccination in order to enter the country.For more information visit El Salvador’s Immigration web site at http://www.seguridad.gob.sv/Web-Seguridad/Migracion/migracion.htm.

Information on vaccinations and other health considerations, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.Further health information for travelers is available at http://www.who.int/ith.

MEDICAL INSURANCE: The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.It may be possible to purchase supplemental coverage for travel.U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States.Separate insurance should be obtained for medical evacuation, as it may cost in excess of $50,000.Many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas, including emergency medical services and even transportation of remains, in the event of death.Please see our information on medical insurance overseas. TRAFFIC SAFETY AND ROAD CONDITIONS:While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.The information below concerning El Salvador is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Road conditions throughout El Salvador are not up to U.S. standards.However, the rebuilding of major roads following the earthquakes in 2001 is nearly completed.Mini-buses, buses, and taxis are often poorly maintained.Drivers are often not trained, and generally do not adhere to traffic rules and regulations.The U.S. Embassy recommends that its personnel avoid using mini-buses and buses, and use only taxis that are radio-dispatched or those stationed in front of major hotels.Robberies and assaults on buses are commonplace. Because of inconsistent enforcement of traffic laws in El Salvador, drivers must make an extraordinary effort to drive defensively.Passing on blind corners is commonplace.Salvadoran law requires that the driver of a vehicle that injures or kills another person must be arrested and detained until a judge can determine responsibility for the accident.This law is uniformly enforced. Visitors to El Salvador may drive on their U.S. license for up to thirty days.After that time, a visitor is required to obtain a Salvadoran license.Please refer to our Road Safety page for more information.Visit the web site of El Salvador’s national tourist office and national authority responsible for road safety at http://www.elsalvadorturismo.gob.sv/.Further information on traffic and road conditions is available in Spanish from Automovil Club de El Salvador, at telephone number 011-503-2221-0557. AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of El Salvador’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of El Salvador’s air carrier operations.For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa. SPECIAL CIRCUMSTANCES:Travelers intending to carry cell phones from the United States should check with their service provider to determine if the service will be available in El Salvador.Credit cards are acceptable for payment in many-but not all-retail stores and restaurants in major cities.Automatic teller machines with access to major U.S. bank networks are widely available in San Salvador, but less prevalent elsewhere in the country.Please see our information on Customs Information. DISASTER PREPAREDNESS:El Salvador is an earthquake-prone country.Flooding and landslides during the rainy season (June to November) also pose a risk.On October 4, 2005, the Government of El Salvador declared a nation-wide state of emergency following major flooding caused by a series of storms.More than 50 deaths were confirmed as attributed to landslides and flooding at that time and over 34,000 residents were evacuated to temporary shelter.The Llamatepec Volcano, located approximately 50 kilometers west of San Salvador, erupted briefly on October 1, 2005, casting rocks and volcanic ash onto neighboring regions and producing two confirmed deaths.General information about natural disaster preparedness is available via the Internet from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/. An earthquake measuring 7.6 on the Richter scale devastated much of El Salvador on January 13, 2001.A second earthquake on February 13, 2001, measured 6.6 on the Richter scale, and caused significant additional damage and loss of life.Reconstruction efforts are largely complete and the country has returned to normal.Additional information in Spanish about earthquakes (sismos) in El Salvador can be found on the Government of El Salvador’s web page at http://www.snet.gob.sv/. CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.Penalties for breaking the law can be more severe than in the United States for similar offences.Persons violating El Salvador’s laws, even unknowingly, may be expelled, arrested or imprisoned.Penalties for possession, use, or trafficking in illegal drugs in El Salvador are severe, and convicted offenders can expect long jail sentences and heavy fines.Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.Please see our information on Criminal Penalties.

Guns:El Salvador has strict laws requiring a locally obtained license to possess or carry a firearm in the country.The Embassy strongly advises persons without a Salvadoran firearms license not to bring guns into the country or use a firearm while in El Salvador.During a three-month period in 2006, three U.S. citizens were arrested in separate incidents for firearms violations.In each instance, the individuals complied with airline procedures, declared the firearm on a Customs form upon arrival at El Salvador's Comalapa International Airport, and were allowed to depart the airport without hindrance.However, when the individuals returned to the airport and declared the weapons to airline employees, they were arrested by Salvadoran police, not for violating aviation regulations but for having carried an unlicensed firearm while in El Salvador.The Embassy cannot intervene in the judicial process when a U.S. citizen is charged with a firearms violation.Conviction for possessing an unlicensed firearm can carry a prison sentence of three to five years.

REGISTRATION / EMBASSY LOCATION: Americans living or traveling in El Salvador are encouraged to register with the U.S. Embassy through the State Department’s travel registration web site, and to obtain updated information on travel and security within El Salvador.Americans without Internet access may register directly with the Embassy.By registering, American citizens make it easier for the Embassy to contact them in case of emergency.The Consular Section of the U.S. Embassy in San Salvador is located at Final Boulevard Santa Elena Sur, Urbanizacion Santa Elena, Antiguo Cuscatlan, La Libertad, telephone 011-503-2501-2999, fax 011-503-2278-5522, e-mail: CongenSansal@state.gov.The Embassy's web site can be accessed at http://sansalvador.usembassy.gov/.The Consular Section is open for U.S. citizens’ services from 8:15 a.m. to 11:30 a.m. weekdays, excluding U.S. and Salvadoran holidays.After business hours, the Embassy can be contacted by telephone at 011-503-2501-2316 or 011-503-2501-2253. For any questions concerning U.S. visas for either temporary travel to or permanent residence in the U.S., please contact our regional U.S. Visa Information Center.From El Salvador, the Visa Information Center may be reached by calling 900-6011 from any landline operated by Telecomm, or by purchasing a VISAS-USA calling card from any location that sells Telefonica phone cards.Calling instructions are on the back of the card.Calls using the 900 number cost approximately $2.15 per minute and will be charged to the caller's telephone bill.The Telefonica phone card costs $15.00 and permits a seven-minute call.From the U.S., the Visa Information Center can be contacted by dialing 866-730-2089 and charging the call to a Visa or MasterCard credit card.*

*

*This replaces the Country Specific Information for El Salvador dated October 2007, to update the format and sections on Entry/Exit Requirements, Crime, Information for Victims of Crime, Medical Facilities and Health Information, Disaster Preparedness, and Registration and Embassy Location.

San Salvador, May 30, 2019 (AFP) - A 6.6 magnitude earthquake struck off the coast of El Salvador on Thursday near the capital but authorities said there were no initial reports of casualties or damage. The quake was so strong it was likely felt throughout Central America, officials said. The quake struck in the Pacific Ocean around 25 miles (40 kilometres) south of San Salvador at a depth of 40 miles (65 km), according to the US Geological Survey.

The Salvadoran environment ministry said the quake was even stronger, with a magnitude of 6.8. The Pacific Tsunami Warning Center did not issue an alert for the quake. But the Environment Ministry issued one of its own, predicting sea level variations of up to 12 inches (30 centimetres). However, Environment Minister Lina Pohl said the alert was sent "as a protocol." Coastal residents should avoid entering the water for four hours after the quake, the ministry said on Twitter.

President-elect Nayib Bukele, who takes office on Saturday, said on Twitter that the earthquake was felt "throughout 100 percent of the country." Police and firemen fanned out across the country to evaluate the situation and reported "no serious or generalized damage," the Civil Protection department said on Twitter. The Education Ministry cancelled classes in coastal areas. In the coastal town of Puerto de la Libertad, authorities evacuated families who live near the water. Rattled residents stood outside their homes Thursday morning digesting the quake. "The quake was very strong. Thank God, nothing happened to me. But we are taking precautions," one of them, Maria Valencia, told Canal 21 television.

The Environment Ministry reported as many as 12 aftershocks ranging from 3.3 to 4.9 in magnitude. In San Salvador, police and soldiers patrolled streets but people largely stayed indoors despite the scare from the quake. The government gave slightly different figures for its location. It placed it more shallow than the USGS at 48 kilometres, and said the epicentre was a bit further out to sea, some 66 kilometres from Puerto de La Libertad.

According to MINSAL [El Salvador's Ministry of Public Health] figures for week 12 (updated till 23 Mar) 2019, the number of cases of typhoid fever remains high. They have reported 517 cases in 2019, compared to 313 cases in 2018, which is equivalent to an increase of 65%.

The head of health surveillance of the ISSS [El Salvador's Social Security Institute], Jose Adan Martinez, said that the figures themselves reflect an increase of 44%. It is worth mentioning that the MINSAL presents the data at the national level, which include those of the ISSS, FOSALUD [El Salvador Solidarity Fund for Health], and other institutions.

"We have been experiencing this upward trend in the disease since the beginning of 2019, and it has increased in the last week," Martinez said.

He also recalled that this is a disease transmitted by water or food contamination. "Given the scarcity of water that has been in some sectors of San Salvador, which is the most affected department, [the increase] could be due to the lack of hygiene measures that the population is taking, both for the preparation of food and for water consumption," he added. [Byline: Edwin Teos]

========================

[Vaccine intervention is an important step, as increasing antimicrobial resistance in the typhoid bacillus in Asia has made treatment more difficult.

Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the more common kinds of salmonellosis. Epidemiologically, usually spread by contaminated food or water, typhoid is not a zoonosis like the more commonly seen types of salmonellosis. Clinically, vomiting and diarrhoea are typically absent; indeed, constipation is frequently reported. As it is a systemic illness, blood cultures are at least as likely to be positive as stool in enteric fever, particularly early in the course of the infection, and bone marrow cultures may be the most sensitive.

The symptoms of classical typhoid fever typically include fever; anorexia; lethargy; malaise; dull, continuous headache; non-productive cough; vague abdominal pain; and constipation. Despite the (often high) fever, the pulse is often only slightly elevated. During the 2nd week of the illness, there is protracted fever and mental dullness, classically called coma vigil. Diarrhoea may develop but usually does not. Many patients develop hepatosplenomegaly (both liver and spleen enlarged). After the 1st week or so, many cases develop a maculopapular rash on the upper abdomen. These lesions ("rose spots") are about 2 cm (0.78 inch) in diameter and blanch on pressure. They persist for 2-4 days and may come and go. Mild and atypical infections are common. The word typhoid (as in typhus-like) reflects the similarity of the louse-borne rickettsial disease epidemic typhus and that of typhoid fever; in fact, in some areas, typhoid fever is still referred to as abdominal typhus. - ProMED Mod.LL]

All the departments of the country experienced significant rises in typhoid fever in the 1st 6 months of 2018, with the exception of Cabanas, in comparison with the figures for the 1st 6 months of 2017. The statistics were provided by the Information and Response Office of the Ministry of Health (MINSAL), at the request of The Graphic Press. According to the data, the departments that registered the highest increases were San Miguel, San Salvador, La Paz and Sonsonate. Throughout 2017, San Miguel, for example, reported 9 cases of typhoid fever; while only between January and June 2018, cases rose to 17.

In San Salvador, cases for 2017 totalled 427, but during the 1st months of 2018 only, they totalled 653. Although the increase was noticed by the Salvadoran Social Security Institute (ISSS), through a press release issued on 8 Feb 2018, the Ministry of Health (MINSAL) spent several weeks without issuing any report with official data and did not speak of the outbreak until several months later, a few days after the end of June 2018. After the ISSS report, some physicians and infectious disease experts also reported an increase in cases of infection caused by the _Salmonella_ Typhi bacterium in private clinics and hospitals.

By mid-February 2018, MINSAL confirmed that there was a 30% increase in cases, compared to the same period in 2017: from 56 to 73. However, it did not include the statistics in its weekly epidemiological surveillance bulletins, for which the medical association denounced the lack of transparency with respect to the preventive management of the disease, which if not treated in time can be fatal. The Minister of Health, Violeta Menja­var, even admitted at that time that there was no vaccine against typhoid fever in the public health network. "In the vaccination scheme, there is not one; so that we can produce a vaccine against typhoid, we have to wait for the one being prepared by the Pan American Health Organization (PAHO), since there is not one that meets the conditions; we have incorporated it into the vaccination scheme," he explained.

The abysmal difference between 622 confirmed cases in the ISSS network, which serves only 17% of the population, and zero confirmed cases in the national public network, which serves more than 80% of the population, generated even more doubts than certainties about the management of the disease by the MINSAL. Finally, in the 2nd half of June 2018, Minister Menja­var acknowledged that there was an outbreak of typhoid fever that affected mainly 28 municipalities in the country, although she suggested that the effect was moderate and not high. "This year [2018], we have almost double that of 2017; it has happened that in 28 municipalities we have an epidemic outbreak; it is not epidemic because that would have to be in the entire country," she said.

The total numbers of cases of 2017 were 675, while the total between January and June of 2018 rose to 937. The authorities have reiterated on several occasions that this disease is directly related to the hygiene habits of people, so they have emphasized, to the point of exhaustion, that the population should take necessary precautions to avoid contagion, especially with surveillance of water quality in water used to cook food or for consumption. Drinking water, however, is the product that has been most scarce in recent months. At the end of March 2018, there was chaos due to lack of drinking water at the start of Holy Week, as the Water and Sewerage Administration (ANDA) reported one of its 48-inch main pipes damaged, which affected the San Pedro Metropolitan Area, Salvador (AMSS).

Less than a month ago, ANDA again left a million inhabitants of the AMSS without water, also due to another fault in the same 48-inch pipeline. The municipalities with the highest figures of typhoid fever between January and June 2018 were San Salvador, (205), Mejicanos (70), Soyapango (59) and Apopa (54), in the capital of the country. After San Salvador, which totaled 653 cases in that period, is La Libertad, with 85 cases. [Byline: Evelyn Machuca]===========================[Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the commoner kinds of salmonellosis. Epidemiologically, usually spread by contaminated food or water, typhoid is not a zoonosis like the more commonly seen types of salmonellosis. Clinically, vomiting and diarrhoea are typically absent; indeed, constipation is frequently reported.

As it is a systemic illness, blood cultures are at least as likely to be positive as stool in enteric fever, particularly early in the course of the infection, and bone marrow cultures may be the most sensitive. The symptoms of classical typhoid fever typically include fever, anorexia, lethargy, malaise, dull continuous headache, non-productive cough, vague abdominal pain, and constipation. Despite the (often high) fever, the pulse is often only slightly elevated.

During the 2nd week of the illness, there is protracted fever and mental dullness, classically called coma vigil. Diarrhoea may develop but usually does not. Many patients develop hepatosplenomegaly (both liver and spleen enlarged). After the 1st week or so, many cases develop a maculopapular rash on the upper abdomen. These lesions ("rose spots") are about 2 cm (0.78 in) in diameter and blanch on pressure. They persist for 2-4 days and may come and go.

Mild and atypical infections are common. The word typhoid (as in typhus-like) reflects the similarity of the louse-borne rickettsial disease epidemic typhus and that of typhoid fever; in fact, in some areas, typhoid fever is still referred to as abdominal typhus. - ProMED Mod.LL]

The Minister of Public Health, Violeta Menja­var, said that there is an epidemic outbreak of typhoid fever in some 26 municipalities, not in the entire country. "We have salmonellosis and within it some typhoid cases, an increase of cases in 26 municipalities, which have a mild to moderate affectation ... What does that mean? We are talking about an epidemic outbreak because it is localized; it is not a national epidemic, "Menja­var said on [14 Jun 2018].

The head of the health surveillance unit, Hector Ramos, said that they had 644 cases suspected of typhoid but that it is too early to speak of a decrease. "We have to wait but it seems that it is starting to level off and we hope that it will continue to decrease," said Minister Menja­var. The minister explained that the increase was a surprise because the winter was early as a result of the La Nina phenomenon.

The epidemiological bulletin of the Salvador Ministry of Public Health and Social Assistance (MINSAL) reported moderate activity of typhoid fever in 9 of the country's 262 municipalities. From January 2018 to date, 469 suspected cases of typhoid fever have been hospitalized, of which 346 have been confirmed by blood culture.

In addition to the 9 municipalities moderately affected, there are 19 municipalities mildly affected and none severely affected. During the week of 4 Jun 2018, the epidemiological bulletin reported 644 suspected cases between January and May 2018. 376 cases were reported during the same period in 2017. One person has died in 2018 and one person died in 2017.========================= [Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the commoner kinds of salmonellosis. Epidemiologically, usually spread by contaminated food or water, typhoid is not a zoonosis like the more commonly seen types of salmonellosis. Clinically, vomiting and diarrhoea are typically absent; indeed, constipation is frequently reported.

As it is a systemic illness, blood cultures are at least as likely to be positive as stool in enteric fever, particularly early in the course of the infection, and bone marrow cultures may be the most sensitive. The symptoms of classical typhoid fever typically include fever, anorexia, lethargy, malaise, dull continuous headache, non-productive cough, vague abdominal pain, and constipation.

Despite the often high fever, the pulse is often only slightly elevated. During the 2nd week of the illness, there is protracted fever and mental dullness, classically called coma vigil. Diarrhoea may develop but usually does not. Many patients develop hepatosplenomegaly (both liver and spleen enlarged). After the 1st week or so, many cases develop a maculopapular rash on the upper abdomen.

These lesions ("rose spots") are about 2 cm (0.78 in) in diameter and blanch on pressure. They persist for 2-4 days and may come and go. Mild and atypical infections are common. The word typhoid (as in typhus-like) reflects the similarity of the louse-borne rickettsial disease epidemic typhus and that of typhoid fever; in fact, in some areas, typhoid fever is still referred to as abdominal typhus. - ProMED Mod.LL]

A 31-year-old man who had recently received a diagnosis of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome [AIDS] presented to the emergency department with headache, confusion, and gait instability.

He had immigrated to the United States from El Salvador 6 years earlier. Fever (temperature, 38.9 deg C [102 deg F]) and an ataxic gait were noted on physical examination.

Laboratory test results were notable for a CD4 positive cell count of 60 per cubic millimeter, an HIV viral load of 409 000 copies per milliliter, a positive result for IgG antibodies to _Toxoplasma gondii_, and a negative result for IgM antibodies to _T. gondii_.

Magnetic resonance images of the brain showed a mass measuring 8 by 7 by 6 cm in the corpus callosum and the white matter of the right parietal and occipital subcortical lobes.

The organisms were identified as _Trypanosoma cruzi_ on the basis of partial protozoal 28S ribosomal RNA sequencing. After vector-borne transmission, which occurs mainly in Central America, South America, and some rural areas in Mexico, _T. cruzi_ infection can persist asymptomatically. Immunosuppression predisposes patients to _T. cruzi_ reactivation in the brain, which can manifest as a brain abscess or meningoencephalitis.

The patient received benznidazole, followed by the initiation of antiretroviral therapy. After 2 weeks of treatment, clinical improvement was noted in his mentation and gait.

======================

[The case underlines that one has to expect the unusual in immunocompromised patients and underlines that biopsy is needed also from the brain in order to reach the correct diagnosis. The guide to the suspicion of a _T. cruzi_ infection is the history of immigration from an endemic area. We do not know if the patient was seropositive for _T. cruzi_ antibodies. - ProMED Mod.EP]

Tonga

Tonga US Consular Information SheetJanuary 27, 2009 COUNTRY DESCRIPTION:Tonga is a South Pacific island nation consisting of 171 islands, of which 45 are inhabited.Tonga is a constitutional monarchy and a member of the British Comm
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nwealth.Its agrarian economy is developing and its tourist industry, although limited, is growing.Tourist facilities are concentrated in and around the main island of Tongatapu where the capital, Nuku’alofa, is located. The Tongan Tourist Bureau has a wide range of information of interest to travelers.The web site is http://www.tongaholiday.com/.Read the Department of State Background Notes on Tonga for additional information.

ENTRY/EXIT REQUIREMENTS:A passport and an onward/return ticket are required.Visas are not required for stays of up to 30 days.Tonga collects a departure tax.For further information about entry requirements, travelers, particularly those planning to enter by sea, may wish to contact the Consulate General of Tonga at 360 Post Street, Suite 604, San Francisco, California 94108; telephone 415-781-0365.

Information about dual nationality or the prevention of international child abduction can be found on our web site.For further information about customs regulations, please read our Customs Information sheet.

SAFETY AND SECURITY:An organized movement for political reform exists in Tonga.Protests in November 2006 became violent, resulting in fires that destroyed much of the downtown area of Nuku’alofa.American citizens are advised to avoid large public gatherings and to exercise caution if within the vicinity of any demonstrations, as they could turn violent at any time.

For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found.

Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll-free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444.These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State's pamphlet A Safe Trip Abroad.

CRIME:Although the crime rate in Tonga is low compared to crime rates in the U.S. and most European countries, petty crime and theft do take place.Though rare, crimes against persons occur as well.Visitors should not be complacent regarding personal safety or the protection of valuables.

INFORMATION FOR VICTIMS OF CRIME:The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the U.S. Embassy in Suva, Fiji at (679) 331 4466 (ask for American Citizen Services).If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. embassy or consulate for assistance.The embassy/consulate staff can, for example, assist you to find appropriate medical care, to contact family members or friends and explain how funds canbe transferred.Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney, if needed.

The local equivalents to the “911” emergency line in Tonga are 911, which connects to the Tonga Telecommunications emergency operators; 922, which connects directly to the police; and 933, which connects directly to the hospital.Americans requiring immediate emergency services in Tonga should call one of these emergency contact numbers.

See our information on Victims of Crime.

CRIMINAL PENALTIES:While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.Penalties for breaking the law can be more severe than in the United States for similar offenses.Persons violating Tongan law, even unknowingly, may be expelled, arrested or imprisoned.Penalties for possession or use of, or trafficking in, illegal drugs in Tonga are severe, and convicted offenders can expect long jail sentences and heavy fines.Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.Please see our information on Criminal Penalties. SPECIAL CIRCUMSTANCES:Tonga’s customs authorities may enforce strict regulations concerning temporary importation into or export from Tonga of items such as firearms, explosives, motor vehicles, eggs and certain types of alcohol.It is advisable to contact the Consulate General of Tonga in San Francisco for specific information regarding customs requirements.Please see our Customs Information. MEDICAL FACILITIES AND HEALTH INFORMATION:Medical facilities in Tonga are extremely limited.The cities of Nuku'alofa and Neiafu have hospitals with limited emergency and outpatient facilities.Local residents and visitors with serious medical problems are often referred to New Zealand for treatment.For additional information on medical visas for New Zealand, contact the Embassy of New Zealand, 37 Observatory Circle NW, Washington, DC 20008, (202) 328-4800 or the Consulate General in Los Angeles (310) 207-1605.Serious medical conditions requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.Doctors and hospitals often expect immediate cash payment for health services.

Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC's web site at http://wwwn.cdc.gov/travel/default.aspx.For information about outbreaks of infectious diseases abroad, consult the World Health Organization's (WHO) web site at http://www.who.int/en.Further health information for travelers is available at http://www.who.int/ith/en The Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Toga.

MEDICAL INSURANCE:The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.Please see our information on medical insurance overseas.

TRAFFIC SAFETY AND ROAD CONDITIONS:While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.The information below concerning Tonga is provided for general reference only, and may not be totally accurate in a particular location or circumstance.

No roadside assistance is available.Traffic moves on the left in Tonga.While roads in Nuku’alofa are paved, most other roads are not.Animals and unwary pedestrians walking in the road make night driving on unlit secondary roads hazardous.For specific information concerning Tonga driving permits, vehicle inspection, road tax and mandatory insurance, contact the Consulate General of Tonga in San Francisco.

Please refer to our Road Safety page for more information.Visit the website of the country’s national tourist office and national authority responsible for road safety at http://www.tongaholiday.com/ AVIATION OVERSIGHT:The U.S. Federal Aviation Administration (FAA) has assessed the Government of Tonga’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Tonga’s air carrier operations.For further information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa/. U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times, so that if questioned by local officials, proof of identity and proof of U.S. citizenship are readily available.U.S. citizens who are detained are encouraged to request that a consular officer from the U.S. Embassy in Suva, Fiji, be notified.

The cyclone season is November through April.The Fiji Meteorological Service maintains a Tropical Cyclone Warning Center (TCWC) in Nadi serving the Southwest Pacific Region. General information about natural disaster preparedness is available online at http://travel.state.gov/travel/tips/emergencies/emergencies_1207.html and from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov/ CHILDREN’S ISSUES:For information, see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.

REGISTRATION/EMBASSY LOCATION:There is no U.S. embassy or other U.S. diplomatic or consular post in Tonga.The U.S. Embassy in Fiji provides assistance for U.S. citizens in Tonga. Americans living or traveling in Tonga are encouraged to register with the U.S. Embassy in Suva through the State Department’s travel registration web site and to obtain updated information on travel and security within Tonga.Americans without Internet access may register directly with the nearest U.S. embassy or consulate.The U.S. Embassy in Fiji is located at 31 Loftus Street in Fiji’s capital city of Suva.The telephone number is (679) 331-4466; the fax number is (679) 330-2267.Information may also be obtained by visiting the Embassy’s home page at http://samoa.usembassy.gov/.By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.*******This replaces the Country Specific Information for Tonga dated June 16, 2008, to update the section on Medical Facilities and Health Information.

Nuku'alofa, Tonga, April 9, 2020 (AFP) - A resurgent Tropical Cyclone Harold flattened tourist resorts in Tonga Thursday, extending a week-long trail of destruction across four South Pacific island nations that has claimed more than two dozen lives. The cyclone gathered pace as it bore down on the tiny island kingdom, which declared a state of emergency, warning residents to seek shelter from destructive winds and massive sea surges.

By early Thursday it had again become a scale-topping Category Five superstorm -- surprising meteorologists after signs earlier in the week that its intensity was dropping. Packing winds of up to 260 kilometres per hour (160 miles per hour), it cut power in parts of the country and police said at least three tourist resorts north of the capital Nuku'alofa had been reduced to rubble.

The cyclone killed 27 people in the Solomons late last week before barrelling southeast to directly hit Vanuatu as a Category Five, obliterating entire towns in the northern provinces. There have been no reports of deaths in Vanuatu, Fiji or Tonga, with emergency workers saying residents in the hardest hit areas took shelter early. "It appears that many buildings and crops have been destroyed and some people in the most affected areas have lost everything," Red Cross Vanuatu secretary general Jacqueline de Gaillande said.

Harold weakened slightly to a still-formidable Category Four as it lashed Fiji on Wednesday but hopes the storm was dissipating were dashed as it regathered momentum heading towards Tonga. "It's been a tricky one to predict," meteorologist Bill Singh from New Zealand's Metservice told AFP. "We knew the track it was going to take but initially everyone thought it was just going to be Cat 3 or 4, but as it progressed over open warm waters it deepened."

- Closed borders -The storm is expected to head away from Tonga onto the open ocean late Thursday but WeatherWatch.co.nz head forecaster Philip Duncan said there were no certainties. "It's almost unheard of to see a cyclone tracking south away from the equator, weakening, then suddenly returning back to Cat 5 so far south," he said.

The COVID-19 pandemic has complicated disaster relief efforts, with Vanuatu reluctant to open its international borders as it seeks to remain one of the few countries without any confirmed virus cases. "No foreign personnel are being brought to Vanuatu for response efforts at the present time, this will be an internally run operation," Vanuatu's National Disaster Management Office said.

Fiji has 15 virus cases and Prime Minister Frank Bainimarama said the virus and cyclone meant "our economy and our people have been dealt two body blows to start the year". "This storm must not compromise our coronavirus containment efforts, lest we risk damage far more painful than the aftermath of any cyclone," he said.

Australian Foreign Minister Marise Payne said an air force plane carrying essential supplies such as tents and water containers was on its way to Vanuatu, while assistance had also been offered to other impacted nations. "We are acutely conscious that this comes on top of the impact and difficulties created by COVID-19 for those countries," she said. Vanuatu said any supplies that came into the country would be handled with protective equipment and the air crews delivering them would be isolated in transit areas.

Tonga measles outbreak situation report from government of Tonga as at 17 Jan 2020

1. Summary of Situation

Background

The outbreak of measles in Tonga began in early October 2019, following the return of a national youth team of Tongan rugby players from New Zealand. The index case developed measles while in New Zealand. Subsequently, a further 12 teammates developed laboratory-confirmed measles. The early outbreak involved mainly teenagers from associated schools on Tongatapu and Vava'u Islands. Since the initial 2 waves of the outbreak, cases were widely reported in all age groups but are now waning.

An interdisciplinary Ministry of Health epidemic task force (ETF) meets weekly to advise on management of the outbreak. In addition to routine outbreak response activities, a time-limited vaccination program targeting secondary school students and 6-11-month infants has been completed.

Note: Refer to earlier sit reps for further detail of the initial cases and response.

2. Current Situation

There is ongoing transmission on the Islands of Tongatapu and Vava'u; the last case onsets on Ha'apai, 'Eua, and Niuatoputapu islands were 14 Dec 2019, 8 Dec 2019, 14 Nov 2019, respectively [Table 1]. Since the last situation report, 6 new measles case-patients were reported in Tongatapu, and 3 cases were added retrospectively to the cumulative number of cases. They were 7 males and 2 females between the ages of 6 months and 19 years old.

As of 16 Jan 2020, 639 confirmed or suspected cases of measles have been identified in Tonga including 52 lab-confirmed cases. The majority, 561 (87.8%) cases, have occurred on Tongatapu, and 66 (10.3 %) have occurred on Vava'u Island. Case presentations have been reported to be mild with 20 hospitalisations and no death. The majority of the cases have been managed by home isolation, and all patients have been discharged. Given the duration of illness is typically less than 2 weeks, it is estimated that at least 99% of the 639 reported measles cases will have already recovered from their illnesses.

Figure 1 (see URL) shows the epidemic curve for the current outbreak in Tonga. Most of the cases (blue) were reported from the Island of Tongatapu.

Figure 2 demonstrates the breakdown of cases by gender. Consistent with early transmission through male boarding schools, most cases have been among males, with the proportion of cases among females increasing as the outbreak progressed. A total of 105 cases have occurred in children aged less than 5 years, while cases among adolescents and young people continue to form the majority of the cases in this outbreak (500 cases, 78%, occurring in people aged 10-24 years) (Table 2 and Figure 3).

Nuku'alofa, Tonga, Nov 14, 2019 (AFP) - All government primary schools and kindergartens in Tonga have been shut in an effort to limit the spread of measles sweeping through the South Pacific, the government announced Thursday. With the number of confirmed and suspected measles infections in the Pacific kingdom nearing 200, Education Minister Siaosi Sovaleni said schools would be closed until at least November 25. "Children who happen to have measles during the closure will be able to be treated and stay isolated from others," he said.

A victory parade to celebrate Tonga's recent historic rugby league wins over Australia and Great Britain would go ahead Friday, but spectators have been advised to wear masks, and an opportunity for school children to meet the players has been cancelled. In Samoa, where seven suspected measles-related deaths have been recorded, a measles epidemic has been declared and the government has taken steps to close all schools.

Neighbouring American Samoa announced a public health emergency Thursday and Governor Lolo Matalasi Moliga said everyone travelling from Tonga and Samoa to the US territory must provide proof of measles immunisation, as a condition of entry. In the tourism-reliant Cook Islands, authorities said there were too many visitors to screen them all and preparations were under way to deal with a potential outbreak. "We are hoping we can hold," Health Secretary Josephine Aumea Herman told Radio New Zealand. Measles is a highly infectious airborne disease that spreads easily through breathing, coughing, and sneezing. It typically causes a rash, fever and white spots in the mouth. More serious complications include blindness, pneumonia, brain damage and severe dehydration.

Nuku'alofa, Tonga, Nov 4, 2019 (AFP) - A 6.6 magnitude earthquake struck off the coast of the Pacific island nation of Tonga on Tuesday, but there was no threat of a tsunami, officials said. The United States Geological Survey (USGS) said the shallow undersea quake hit about 134 kilometres (83 miles) west of Neiafu, the country's second-largest town. It said the temblor was not expected to have caused significant damage. The quake was not felt in Tonga's capital, Nuku'alofa, according to an AFP reporter. There was also no threat of a tsunami, the Pacific Tsunami Warning Center said. A second quake of 5.5 magnitude was recorded a few minutes later, the USGS said.

Tonga's Ministry of Health today [Tue 22 Oct 2019] issued a measles alert after 13 members of a Tongan school rugby team developed measles after returning from New Zealand this month [October 2019]. Measles is a highly infectious disease, and the public is urged to be vigilant for signs and symptoms and to get immunized, especially if they are traveling overseas.

The high school rugby group were playing rugby in New Zealand in September [2019]. There were 60 boys and 8 officials in the group. One of the boys became unwell while in New Zealand and was laboratory confirmed as having measles.

Since their return to Tonga on 1 Oct [2019], 13 other members of the group developed symptoms of measles. Six of those cases had been confirmed by a laboratory test.

Another person who was in contact with one of the players was a suspected case, bringing the total number to 15 cases.

None of the cases are seriously ill.

The Ministry reported that it had taken rapid steps to prevent further spread of the virus, including isolating the current cases at home, vaccinating contacts of the cases, and quarantining the remaining squad members, staff, and other contacts.

Ministry of Health CEO, Dr Siale 'Akau'ola said that parents of players have been contacted and provided with information about measles, and the boys were instructed to remain at home until they were sure that they would not develop measles.

"The Ministry is confident that steps have been taken to contain the spread of the virus. However, measles is a highly infectious disease, and it is possible that further cases may occur."

New Zealand has a major outbreak of measles with more than 1800 cases since the beginning of the year [2019].

People travelling to New Zealand and other countries experiencing measles outbreaks are strongly recommended to check their immunization status.

World Travel News Headlines

Nicosia, June 6, 2020 (AFP) - Cyprus opens back up for international tourism on Tuesday, with airports welcoming visitors after an almost three-month shutdown, and a bold plan to cover health care costs for visitors. But with arrivals expected to be down by 70 percent this year due to the chaos brought by the COVID-19 pandemic, it's a leap of faith for the small Mediterranean holiday island. "Nobody here is expecting to make any money this year", Deputy Tourism Minister Savvas Perdios told AFP. "We are setting the stage for the beginning of our recovery in 2021."

The divided island's tourism sector normally accounts for around 15 percent of GDP but has dried up in past months amid global measures to combat the spread of the novel coronavirus. Cyprus saw a record 3.97 million arrivals in 2019, with more than half its market made up of British and Russian visitors. But even if the island's airports in Larnaca and Paphos will open up to arrivals on Tuesday with the first flight due to arrive from Athens around midday (0900GMT), neither Britain or Russia are among the 19 countries allowed to land there.

The list of permitted countries, which also include Bulgaria, Germany and Malta, have been chosen based on epidemiological data and split into two categories. Initially all travellers will need to show proof of a negative COVID-19 test undertaken within 72 hours of travel, but from June 20, only those arriving from six countries in the second category, such as Poland and Romania, will need to do so. The government says the lists will be revised weekly and more countries can be added.

Cyprus will also cover accommodation, dining and medical care for any tourists who fall ill with the COVID-19 illness during their stay, as well as accommodation and meals for their families and close contacts. "What we offer and what we sell is not the sun and the sea, it's hospitality, and this is an extension of our hospitality," Perdios said. The government has designated a 100-bed COVID-19 hospital for tourists that Perdios said would be located in the Larnaca region, while 112 ICU units have been allocated for visitors. Perdios said several four-star hotels would provide 500 quarantine rooms for close contacts of those who fall ill.

- 'Right thing to do' -A raft of other health measures, including disinfection protocols and temperature checks at border controls, aim to protect travellers and locals alike. "We've gone to big lengths to think ahead of things that could go wrong and try to devise plan Bs and Cs", Perdios said. The Republic of Cyprus, in the south of the island, has registered 960 novel coronavirus cases and 17 deaths. Perdios expressed hope that British tourists could be welcomed "sometime after mid-July", with Russia "slightly later, maybe by a couple of weeks".

A recently announced deal with Hungarian low-cost carrier Wizz Air to open a base in Cyprus from July was also an important step towards expanding and diversifying the island's tourist markets, he said. While no date has been set to allow international tourists to visit the breakaway Turkish Republic of Northern Cyprus, only recognised by Ankara, the health care commitment would still apply to those visiting the north during their stay once the crossings are reopened. "I am very confident that not only will we be able to continue providing our citizens with protection, but also caring for everybody who comes to the island on holiday", he said. "If we are coming out with a scheme like this, it's because we can afford it, but most importantly, because we feel that it's the right thing to do."

Orlando, June 5, 2020 (AFP) - Tourists donned masks Friday and visited the attractions at Universal Orlando, the first of the major theme parks in Florida to open since the COVID-19 pandemic shut them down almost three months ago. Universal Orlando resort and the other theme parks in this central Florida city closed on March 15 to prevent the spread of coronavirus. New back-to-fun rules at the park include temperature controls at the entrance, mandatory use of face masks, markers on the ground to help enforce social distancing and posters thanking the public for their help "during this unprecedented time."

Universal Orlando is only reopening at 35 percent capacity and has launched a system of virtual lines in which space can be reserved, to avoid queues and crowds. Terrence Wilson, 19, was happy with the result. "There's not a lot of people. I can get on all the rides without having to wait 40 minutes or an hour" he told the Orlando Sentinel.

On Monday, the Legoland Florida park opened in the city of Winter Haven, while SeaWorld in Orlando is scheduled to open on June 10. The largest of Orlando's parks, Walt Disney World, will open on July 11. That day the park's Magic Kingdom and Animal Kingdom sections will begin operating, while EPCOT and Hollywood Studios will follow suit on July 15. Orlando is home to most of the state's theme parks and every year welcomes millions of tourists from all over the world.

Riyadh, June 5, 2020 (AFP) - Saudi Arabia on Friday announced a renewed lockdown in the city of Jeddah, gateway to the annual Muslim pilgrimage to Mecca, to counter a new spike in coronavirus cases. "After reviewing the epidemiological situation and the high occupancy rates of intensive care departments, it was decided to take strict health precautions in the city of Jeddah for two weeks," starting from Saturday, the health ministry said. The measures include a curfew running from 3 pm to 6 am, a suspension of prayers in mosques and a stay-at-home order for public and private sector workers in the Red Sea city whose airport serves Mecca pilgrims.

After an easing of precautions in the kingdom in late May, the ministry said that strict measures could also soon return to Riyadh, which was "witnessing a continuous increase during the last days" of critical cases of the pandemic. Saudi Arabia has declared almost 96,000 coronavirus infections and 642 deaths from the Covid-19 respiratory disease, the heaviest toll in the Gulf. It has suspended the year-round "umrah" pilgrimage to Mecca and Medina over fears of the coronavirus pandemic spreading to Islam's holiest cities.

Authorities are yet to announce whether they will proceed with this year's hajj, scheduled for the end of July, but have urged Muslims to temporarily defer preparations for the annual pilgrimage. Last year, some 2.5 million faithful travelled to Saudi Arabia from across the world to take part in the hajj, which all Muslims must perform at least once in their lives if able.

Dublin, June 5, 2020 (AFP) - Ireland will dramatically accelerate its plan to ease coronavirus lockdown restrictions in the coming days, Prime Minister Leo Varadkar said Friday. "Today I can confirm that it is safe to move to phase two of the plan to reopen our country starting on Monday," Varadkar told a press conference. "I'm also announcing an acceleration of the roadmap." More workplaces will open and household visits will be permitted from Monday in line with the government plan to reopen the Republic announced in May.

However an escalation of the scheme will see citizens allowed to travel across their county of residence and/or up to 20 kilometres (12 miles) from home. All shops will also be permitted to reopen whilst the final stage of the "roadmap" to end lockdown -- in place since 28 March -- will be brought forward from August to July. Playgrounds will reopen while the government now intends to allow hotels, restaurants and bars serving food to resume trade on June 29. "We are making progress, we are heading in the right direction, and we have earned the right to be hopeful about the future again," Varadkar said. Ireland has suffered 1,664 deaths from the coronavirus, according to official figures. Recorded deaths peaked at 77 in a single day in April, but by Thursday that figure had fallen to just five.

The Republic last Monday registered its first day without any COVID-19 deaths in more than two months, one week after entering the first phase of its plan to leave lockdown. "We've proved we can suppress the virus, but now we do face another test," said health minister Simon Harris. "We must prove we can live alongside it and keep it weak at the same time."

The easing includes provisions for shops to hold staggered opening hours and social distancing measures to remain in place. "We must remain careful, cautious vigilant, and together," Harris added. Finance minister Paschal Donohoe announced Friday that a government wage subsidy scheme enacted when the nation entered lockdown will be extended until the end of August. To date, 1.37 billion ($1.55 billion) euros has been paid to half a million employees. But he warned "this support cannot last forever" and he expected to see a continued decline in reliance on the scheme.

Quito, June 5, 2020 (AFP) - As much of Ecuador went into lockdown against the coronavirus, scientists shipped out of the Galapagos, leaving important research activity frozen and the Pacific archipelago's tourism in deep crisis. Authorities are desperately hoping for a revival of the vital tourism industry -- the main engine of the local economy -- once visitors are allowed to fly in again from July 1.

In the meantime, local officials say they have to take a leaf out of English naturalist Charles Darwin's book and "adapt to survive." Darwin based his theory of evolution on his studies of the islands' unique flora and fauna. But dozens of researchers following in his footsteps had to leave before air links were shut down as the pandemic advanced. "Science has to a large extent been paralyzed these days in the Galapagos," Diego Quiroga of Quito's San Francisco University told AFP.

Sixteen researchers of various nationalities from the university's Galapagos Science Center were repatriated along with 50 US students when Ecuador shut its borders, suspended flights and imposed strict restrictions on movement in mid-March. The move meant that the Galapagos was largely spared the devastating impact of the virus felt on the mainland. Ecuador, a country of 17 million, has more than 40,000 infections with 3,500 deaths. The Galapagos is the least affected of its provinces, with fewer than 80 infections among its 30,000 population.

- Research suspended -The 76 projects being carried out under the Center's auspices remain in limbo, and an international congress set to draw 200 scientists to the archipelago was canceled. The Charles Darwin Foundation, which has been operating on the islands for 60 years, had to shelve 20 research programs.

Around 30 of its scientists and volunteers who were carrying out field work "had to abandon their investigation sites," said Maria Jose Barragan, the foundation's CEO and science director. With them went "an important season of investigation into the reproductive cycle of birds" in the Galapagos, she said. The Galapagos National Park (PNG), a public body responsible for conservation of the archipelago, continues to operate.

- Adapting to less -The Charles Darwin Foundation fears, however, the long-term impact of the pandemic on future research. "I think the global picture for the conservation sector, regarding acquisition and availability of funds, will change becaus there will likely

be other interests" competing for funds, said Barragan. "We have to adapt, which is actually the principle of the theory of evolution: change and adapt," she said.

Galapagos Science Center head Carlos Mena says he does not believe "funding for science is decreasing, but yes, it will move to other sectors, such as economic rejuvenation or the study of diseases and viruses." As things stand, any freeze in research projects affects livelihoods on the archipelago. Mena says this will translate into almost a million dollars in lost revenue for 2020. "Science brings in revenue. It's not huge, not like tourism, but yes, it generates revenue."

In the months of lockdown, between March and May, the Galapagos -- which had more than 270,000 visitors last year -- lost $200 million in tourism revenue, according to the Provincial Chamber of Tourism. "The revenue is zero. There have been no tourists, therefore no admissions to the park, nor the economic revenue" they generate, said park director Andres Ordonez.

Mena believes tourism will come back stronger after the coronavirus, saying the work of researchers can "serve as a guide for better tourism" in the islands with their fragile ecosystems. "The Galapagos have always been considered as a laboratory for studying the evolution of species," he said. "We can also see them as a laboratory for building tourism or a better model of society than before the pandemic."

Rio de Janeiro, June 5, 2020 (AFP) - Brazil's death toll from the novel coronavirus has surged to become the third-highest in the world, surpassing Italy's, according to official figures released Thursday. The South American country of 210 million people reported a new record of 1,473 deaths in 24 hours, bringing its overall toll to 34,021, from 614,941 infections, the health ministry said. Italy has confirmed 33,689 deaths from 234,013 infections.

Johannesburg, June 4, 2020 (AFP) - South Africa said Thursday it had recorded 3,267 novel coronavirus cases in 24 hours, the biggest jump since the pandemic hit the country. Africa's biggest industrial power now has a total of 40,792 infections, the health ministry said. It saw a rise of 56 deaths for a total of 848 fatalities. More than half of the cases are in the Western Cape region where health services are under pressure.

South Africa is the sub-Saharan African country hardest hit by the pandemic. President Cyril Ramaphosa on March 27 ordered South Africans to observe a lockdown aimed at slowing the disease's spread. The move sharply limited people's freedom of movement while slowing an economy already in recession. But Ramaphosa has gradually eased the lockdown measures and allowed most of the economy to restart.

Masks to be compulsory on public transport in England (from the 15th June!)
Disease SARS United Kingdom
- 23 hours ago

Date: Thu, 4 Jun 2020 18:41:36 +0200 (METDST)

London, June 4, 2020 (AFP) - Masks will be compulsory on public transport in England from next week to prevent the spread of the coronavirus, transport minister Grant Shapps said Thursday. "As of 15th June, face coverings will be mandatory on public transport," he said at a daily briefing on the government's response to the coronavirus outbreak. The government had previously advised people to wear face coverings in enclosed spaces such as shops and public transport but stopped short of making them compulsory. They remain only a recommendation in Scotland, Wales and Northern Ireland, whose devolved administrations have responsibility for transport.

The announcement was made as part of plans to ease lockdown restrictions in England, as infection rates and the number of deaths from COVID-19 falls. A total of 39,904 people have died in the outbreak in Britain, according to the latest official figures, which is the second-highest toll in the world after the United States. "We need to ensure every precaution is taken on buses, trains, aircraft and on ferries," said Shapps, calling the use of face coverings a "condition of travel". Small children, the disabled and anyone with breathing difficulties would be exempt, he added. "We expect the vast majority won't need to be forced into this," he said, but warned that anyone refusing to do so could be prevented from travelling or even fined.

Cox's Bazar, Bangladesh, June 4, 2020 (AFP) - Rohingya refugees infected with coronavirus are fleeing quarantine in their Bangladesh camps because they fear being transferred to an isolated island in the Bay of Bengal, community leaders said Thursday. At least two infected refugees have gone missing since testing positive for the virus after the first COVID-19 death was reported Tuesday, they said.

About one million Rohingya -- most of whom fled a military crackdown in Myanmar in 2017 -- are packed into camps along the Bangladesh border, and the coronavirus has become the latest cause of misery. Aid agencies have long warned that the virus could cause chaos in the overcrowded camps, where social distancing is virtually impossible. So far only 29 infections have been detected, although 16,000 Rohingya are in quarantine zones within the camps.

It was not immediately clear how many tests have been conducted in the camps, but a senior health official said two people who proved positive had "fled the isolation hospital". He added that only 20 refugees agreed to be tested in the past two days because they believe those infected will be sent to Bhashan Char island in the Bay of Bengal. "It has created mass panic," Nurul Islam, a community leader, told AFP.

Bangladesh authorities have long wanted to establish a camp for 100,000 people on the isolated island, and have already sent 306 Rohingya there. "The Rohingya are petrified," the health official told AFP on condition of anonymity. "We have told them they won't be sent anywhere."

Some 500 isolation beds have been prepared in the camps, but most are empty because so few confirmed cases have been found, according to the official. The first Rohingya fatality from the coronavirus was announced only Tuesday, and health officials say they desperately need to increase testing to see how widespread the virus may be. But Khalilur Rahman Khan, the government administrator of one camp block, said doctors told him refugees were reluctant to participate.

Several Rohingya leaders said the transfer of the 306 refugees to Bhashan Char had sparked rumours that anyone with coronavirus would be sent to join them. "People are scared to go for virus tests," said Abu Zaman, a community leader. Mohammad Shafi, a camp neighbour of the refugee whose death was announced Tuesday, said people who had coronavirus symptoms such as fever and aches insisted they only had seasonal flu. "I tried to reassure them that this a curable disease and most people will recover, but many don't believe it," he said.

Santiago, June 3, 2020 (AFP) - Chile's government said Wednesday it was prolonging a three-week shutdown of the country's capital Santiago as the COVID-19 death toll reached a new daily record. Health officials said 87 people had died in the previous 24 hours, and nearly 5,000 new infections were recorded. The South American copper-exporting nation has now registered more than 113,000 infections and 1,275 deaths.

Health Minister Jaime Manalich confirmed the government was extending a three-week lockdown of the capital for another week. The city is home to seven million of the country's 18 million population and produces half its GDP. Manalich said the population's mobility had only been reduced by 30 percent, because of a large numbers of permits granted to those needed for essential activities. "There are many permits," the minister said, warning that "for the quarantine to be effective, mobility needs to be reduced by at least 50 percent."

The minister appealed to people to minimize time spent outside of their homes to help reduce infections, especially in the coming weeks when emergency health services are expected to be operating at maximum capacity. Already in Santiago, 97 percent of intensive care unit beds are occupied, while units in the rest of Chile report having reached 88 percent capacity.